Senior Manager: Managed Care

The key focus of the Senior Manager job is to ensure that the managed care functions of the company operate at optimum efficiency levels for multiple medical aid scheme and health insurance clients. Service levels delivered should set the industry benchmark standards for service delivery, clinical outcomes and excellent customer service, that consistently exceed customer expectations.

Key Responsibilities:

• Manage day-to-day activities of operational functions within managed care including (but not limited to) the authorization contact centers of hospital and ambulatory care, the hospital audit and claims division to ensure effective delivery of all contracted services within SLA clients.
• Scope and manage projects to ensure that system, process and people enhancements are implemented that increase operational efficiency, cost savings and improved member experience.
• Implement quality and continuous improvement initiatives within managed care areas, driving and fostering a high-performance culture within the managed care team
• Liaise with all managers in the managed care to drive improvement and best service.
• Translate and align strategic intent relevant to the division into operational goals and manage the performance management process to achieve departmental and divisional goal achievement.
• Work closely with clinical resources to ensure evidence-based medicine is always implemented.
• Interact with managers and senior managers of different areas of the organization with the view to align, optimize and integrate business processes and service delivery.
• Manage, motivate and up-skill the team, developing and growing the team through formal training, mentoring and coaching and skills development.
• Consistently monitoring and analyzing the business processes and performance.
• Monitor and oversee compliance with audit control system procedures and policy, comply with legal requirements and meet all safety standards.  This includes implementation of ISO and any other relevant quality standards.
• Assist with special projects and assignments and take on any other management responsibilities not specifically identified above on an as needed basis.

Experience and Qualifications

• B Com degree or related business degree is essential. Postgraduate qualification is business administration will also be an advantage or an equivalent of 10 years healthcare work experience.
• At least 5 years’ experience at senior management level in managing medical scheme administration or managed care functions

 Essential Skills

• Proven track record of leadership at a senior level
• Excellent report writing skills
• Outstanding communication skills
• The ability to cope with rejection
• Ability to work under pressure
• Ability to attain targets
• The capacity to work alone or as part of a team
• Extreme self-motivation and a competitive nature
• The ability to write detailed yet compelling proposals and reports
• Hardworking, persistent, and dependable.
• Positive and enthusiastic.
• Strong IT skills
• Strong project management skills
• Proficient with Windows, Excel and Word

Language requirements

• English: Primary business language. Be able to speak, write, spell, read and comprehend the language.
• Other languages: The ability to converse in another local language an advantage.

 Closing Date: 19 June 2026