Claims Manager- Individual life

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Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

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 Management

Oversee an operational area with guidance from senior colleagues. Could involve responsibility for development or delivery (or both).

Business Planning

Contribute 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 Direction

Communicate 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 Management

Manage 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 Operations

Manage 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 Allocation

Develop medium- or long-term work schedules that enable the organization to achieve its business goals. Involves coordinating across multiple teams.

Improvement/Innovation

Identify 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 Implementation

Develop 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.

Recommendations

Recommend changes to policies, processes, standards, and practices that would improve operational support.

Internal Communications

Develop and/or deliver a plan for significant aspects of internal communications with guidance from senior colleagues.

Organizational Risk Management

Develop and/or deliver a contingency plan for significant aspects of the risk management and/or risk control processes.

Budgeting

Develop and/or deliver budget plans with guidance from senior colleagues.

Organizational Capability Building

Use 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 Compliance

Monitor 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 Assessments

Competencies

Builds Effective Teams

Communicates Effectively

Customer Focus

Directs Work

Drives Engagement

Drives Results

Ensures Accountability

Financial Acumen

Education

Diploma (Dip)

Closing Date

24 February 2025 , 23:59

The 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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