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Job Description
Use specialist technical knowledge to train and develop Individual Life Claims Assessors both new and ongoing
Manage complaints, decision reviews, escalations and queries
Be an active member of relevant committee meetings and industry engagements
Manage a pre-determined portfolio (e.g. quality, communication, operations, service; complaints, compliance) supported by relevant teams
Facilitate engagement sessions and workshops with Distribution channel stakeholders and multi-disciplinary teams
Problem solve, investigate, identify root cause and resolve management queries relating to Claims
Accountable for execution of tactical business plans (derived from BU Strategy) at operational level.
Manages direct (Claims Assessors, Team Leaders, Claims Specialists) and indirect (Clerical staff) reports, usually amounts to between 40 to 100 staff.
Owns operational efficiency and quality including an operations balanced scorecard incorporating finance, people, process and customer dimensions of the business.
Integrates decision making across all of these spectrums.
Contributes to projects impacting on business deliverables (Delivery of level three plans).
KEY RESULT AREAS
Risk Management
Strong technical knowledge to evaluate, manage and support a claims team
Quality assurance of Claims assessors’ work
Auditing
Fully upskilled and experienced in assessing an Individual Life Risk Product Range, validity and liability requirements with a focus on risk mitigation
Sound understanding of different regulation and legislations applicable to the long-term insurance industry
ROLE REQUIREMENTS
Matric with Biology, Mathematics or Accounting essential
Medical or medically aligned degree, e.g. Nursing, Occupational Therapy, Physiotherapy or a three-year related diploma would be a distinct advantage
Minimum 10 years’ Individual life Claims assessing and technical Claims experience required
Minimum 5 years’ managing a team of Claims Assessors
Specialised medical knowledge through learning or experience essential.
Greenlight & OMP product knowledge essential
In-depth knowledge of systems and system navigation [AWD, OMEGA, Bancs and Bizagi] is essential
Knowledge of external risk mitigation tools (Health Cloud, MDA, ITC etc) would be advantageous
PC proficiency in MS Office i.e. Word, Excel etc.
Well-developed interpersonal and negotiation skills
Manage quality of assessments internally and via Reinsurance partners
Strong verbal and written communication
Attention to detail
Well-developed problem solving skills
Good presentation skills
Must be a team player
Availability to work extra time when there is a business need is essential
Manage the development and implementation of processes, systems, and infrastructure to ensure high quality and timeliness of operations in areas such as account services, international securities, transaction processing, and loan support/credit approval.ResponsibilitiesOperations ManagementOversee an operational area with guidance from senior colleagues. Could involve responsibility for development or delivery (or both).
Business PlanningContribute to the development of annual and longer-term business plans; forecast performance against business key performance indicators (KPIs); develop business cases for key activities/projects; and estimate the financial and human resources required to deliver performance targets.
Leadership and DirectionCommunicate the actions needed to implement the function's strategy and business plan within the team; explain the relationship to the broader organization's mission, vision, and values; motivate people to commit to these and to do extraordinary things to achieve local business goals.
Performance ManagementManage and report on the performance of a substantial, diverse team; set appropriate performance objectives for direct reports or project/account team members and hold individuals accountable for achieving them; take appropriate corrective action where necessary to ensure the achievement of team/personal objectives.
Retail Service OperationsManage day-to-day service operations, developing and/or delivering a plan and outcomes for a service operations area with guidance from senior colleagues.
Work Scheduling and AllocationDevelop medium- or long-term work schedules that enable the organization to achieve its business goals. Involves coordinating across multiple teams.
Improvement/InnovationIdentify shortcomings in existing business practices, then suggest and implement improvements while developing and delivering projects or a work stream within the organization's change management program. Involves working with guidance from senior colleagues.
Policy Development and ImplementationDevelop procedures and interpret and apply policy for area of expertise to achieve specified outputs, or advise the wider business on application of policy, then monitor implementation of those procedures within the organization.
RecommendationsRecommend changes to policies, processes, standards, and practices that would improve operational support.
Internal CommunicationsDevelop and/or deliver a plan for significant aspects of internal communications with guidance from senior colleagues.
Organizational Risk ManagementDevelop and/or deliver a contingency plan for significant aspects of the risk management and/or risk control processes.
BudgetingDevelop and/or deliver budget plans with guidance from senior colleagues.
Organizational Capability BuildingUse the organization's formal development framework to identify the team's individual development needs. Plan and implement actions, including continuing professional development specified by professional or regulatory institutions, to build their professional capabilities. Provide informal training or coaching to others throughout the organization in own area of expertise to enable others to improve performance and fulfill personal potential.
Operational ComplianceMonitor and review performance and behaviors within area of responsibility to identify and resolve noncompliance with the organization's policies and relevant regulatory codes and codes of conduct.
Skills
Action Planning, Backlog Management, Change Management, Data Compilation, Executing Plans, Large Group Presentations, Legal Practices, Occupational Safety and Health, Oral Communications, Organizational Design, Policies & Procedures, Project Budget Management, Project Delivery Management, Readiness AssessmentsCompetencies
Builds Effective TeamsCommunicates EffectivelyCustomer FocusDirects WorkDrives EngagementDrives ResultsEnsures AccountabilityFinancial AcumenEducation
Diploma (Dip)Closing Date
16 February 2025 , 23:59The appointment will be made from the designated group in line with the Employment Equity Plan of Old Mutual South Africa and the specific business unit in question.
Old Mutual Limited is pro-vaccination and encourages its workforce to be fully vaccinated against Covid-19.
All prospective employees are required to disclose their vaccination status as part of the recruitment process.
Please refer to the Old Mutual’s Covid-19 vaccination policy for further detail. Kindly note that Old Mutual reserves the right to reinstate the requirement to vaccinate at any point if it is of the view that it is imperative to do so.
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