Purpose of the Job: Responsible for the smooth running and management of the Claims Origination Department in the province through the effective use of resources and ensuring that all RAF service offerings are executed in compliance with legislation and RAF Policies and Procedures.
Key Performance Areas Management of Department Development the business plans for the CSC aligned with the RAF strategic plan of the RAF. Provide technical assistance to employees within the claims Origination Department in the province. Claims origination include consultations, origination of direct claims, direct claim lodgement, pro-active and re-active information collection, and pre-merits assessment. Manage the activities of the Hospital Service Centres, Community service Centre (including Mobile RAF, Registrations and Validation/Verification, Merits team). Mobilise employees within the province to actively practice the RAF mission, vision, values and strategic objectives. Ensure implementation of continuous improvements initiatives to enhance service delivery & effective reporting. Prepare and submit monthly progress reports to the Senior Claims Manager. Ensure effective and sufficient recording of daily activities of the Department. Ensure the timely completion of financial reports. Ensure adherence to corporate governance within the team. Prepare and manage the annual budget for the CSC in accordance with legislation and RAF targets and goals. Prepare the annual administrative and human resource budget for the budget for the Department in the Region. Ensure that employees adhere to the PFMA. Monitor the departmental expenditure. Stakeholder Management Facilitate communication with all levels of stakeholder contact. Ensure that the RAF values are adhered to in all dealings with stakeholders. Ensure adequate representation of the Fund in relevant external activities and events. Ensure a positive relationship with all internal and external stakeholders.
Ensure external stakeholders are continuously engaged to improve relationships. People Management. Provide leadership and inspire team members towards high performance. Manage performance and development of reporting staff. Provide coaching to team members on an ongoing basis. Set operational goals and targets for teams. Ensure proper planning and allocation of consistent workload within the Department. Facilitate weekly team lead meetings to ensure maintenance of the crucial interface between management and staff. Qualifications NQF 7 (Bachelor's Degree or Advanced Diploma) related qualification to discipline. NQF8 (Post graduate Diploma / Honors Degree / Professional Qualification Degree) Advantageous. Experience 6-8 working experience in a claims/legal environment of which 2 years must have been at a manager/supervisory level. Technical and behavioral competencies required Knowledge of PFMA. Financial and budget management. Knowledge of Claims management system. Insurance / Re-insurance principles. Customer Channels Establishment and Support principles. Strategic capability and leadership Results orientation Business and financial acumen Brand and stakeholder orientation Organizational resilience Communication Team resilience Network and alliances Talent management Change management Purpose of the Job: Responsible for the smooth running and management of the Claims Origination Department in the province through the effective use of resources and ensuring that all RAF service offerings are executed in compliance with legislation and RAF Policies and Procedures.
Key Performance Areas Management of Department Development the business plans for the CSC aligned with the RAF strategic plan of the RAF. Provide technical assistance to employees within the claims Origination Department in the province. Claims origination include consultations, origination of direct claims, direct claim lodgement, pro-active and re-active information collection, and pre-merits assessment. Manage the activities of the Hospital Service Centres, Community service Centre (including Mobile RAF, Registrations and Validation/Verification, Merits team). Mobilise employees within the province to actively practice the RAF mission, vision, values and strategic objectives. Ensure implementation of continuous improvements initiatives to enhance service delivery & effective reporting. Prepare and submit monthly progress reports to the Senior Claims Manager. Ensure effective and sufficient recording of daily activities of the Department. Ensure the timely completion of financial reports. Ensure adherence to corporate governance within the team. Prepare and manage the annual budget for the CSC in accordance with legislation and RAF targets and goals. Prepare the annual administrative and human resource budget for the budget for the Department in the Region. Ensure that employees adhere to the PFMA. Monitor the departmental expenditure. Stakeholder Management Facilitate communication with all levels of stakeholder contact. Ensure that the RAF values are adhered to in all dealings with stakeholders. Ensure adequate representation of the Fund in relevant external activities and events. Ensure a positive relationship with all internal and external stakeholders.
Ensure external stakeholders are continuously engaged to improve relationships. People Management. Provide leadership and inspire team members towards high performance. Manage performance and development of reporting staff. Provide coaching to team members on an ongoing basis. Set operational goals and targets for teams. Ensure proper planning and allocation of consistent workload within the Department. Facilitate weekly team lead meetings to ensure maintenance of the crucial interface between management and staff. Qualifications NQF 7 (Bachelor's Degree or Advanced Diploma) related qualification to discipline. NQF8 (Post graduate Diploma / Honors Degree / Professional Qualification Degree) Advantageous. Experience 6-8 working experience in a claims/legal environment of which 2 years must have been at a manager/supervisory level. Technical and behavioral competencies required Knowledge of PFMA. Financial and budget management. Knowledge of Claims management system. Insurance / Re-insurance principles. Customer Channels Establishment and Support principles. Strategic capability and leadership Results orientation Business and financial acumen Brand and stakeholder orientation Organizational resilience Communication Team resilience Network and alliances Talent management Change management