CIC Insurance Operations Manager (Medical) Job in Kenya

CIC Insurance Group is the leading Co-operative insurer in Africa and one of the top three insurance companies in the country. 

CIC Insurance Group consists of three subsidiaries; CIC General Ltd, CIC Life Assurance Ltd and CIC Asset Management Ltd; currently CIC has businesses operating all over Kenya with 19 branches. 

In order to execute its ambitious growth and expansion strategy, CIC wishes to recruit high caliber individuals to fill the following position:

Operations Manager – Medical

Job Role / Purpose: Ensure a smooth access to cover benefits by clients through effective management of the claims process, including Claims processing, Care service, provider administration, claims recoveries and forensic audits and analyses.

Duties & Responsibilities

• Achieve profitability of the medical business through    effective management of the claims function, including claims vetting and rates negotiation with providers.
• Ensure that the company meets its claims payment obligations to contracted service providers within SLAs.
• Ensure proper management of medical service provider credit accounts through monthly reconciliation and sign offs.
• Oversee an efficient claiming process that facilitates easy and convenient access to quality medical care.
• Maintain a structured Chronic Disease follow-up and management program.
• Participate in cash-flow management by ensuring accurate claims projections.
• Ensure prompt recovery of reinsurance and out-of-scope claims.
• Continuous review and maintenance of the panel list of medical service providers.
• Maintain an accurate claims reserving system.
• Maintain cordial relations with medical service providers, intermediaries and clients as key partners of the business through Continuous communication and updates.
• Work together with other departments within medical division to carry out consistent programs on member sensitization and health talks.
• Control management expenses through operational efficiency.
• Participate in product development and innovation initiatives.
• Ensure a well-trained and highly motivated staff in order to achieve set business targets.
• Timely preparation and submission of management reports.
• Commission random and planned forensic audits of medical service providers, medical schemes and individual claimants as needs arise.
• Minimum: Bachelor’s degree in a relevant field such as Medicine (preferred), Insurance, Economics, Commerce.

Academic Qualifications

• Minimum: Bachelor’s degree in a relevant field such as Medicine (preferred), Insurance, Economics, Commerce.

Professional Qualifications

• Attainment of relevant professional qualifications, E.g ACII or IIK Diploma

Relevant Work Experience

• At least 5 years’ work experience at a Managerial level in a busy Medical claims department, with a reputable insurance company or HMO.

Skills / Knowledge

• Technical competence.
• Excellent presentation and training skills.
• Excellent negotiation skills.
• Excellent communication skills (verbal and written).
• Good analytical and reporting skills
• Listening skills.
• Computer skills
• Leadership skills

If you have the required professional and academic qualifications and you are ready to execute the mandate, kindly send your resume to the address below indicating on the subject of your email the job title.

For example:

Ref : Application for OPERATIONS MANAGER-MEDICAL Position to:
 

The Group Human Resources Manager
CIC Insurance Group Ltd
Strictly through Email to: recruitment@cic.co.ke.

The application should reach us by close of business on 30th May, 2014. 

Please note only short listed candidate will be contacted. 

If you do not hear from us by 30th June, 2014 consider your application unsuccessful.