Job purpose

This role is responsible for supporting the medical management function in the Authority

Key Responsibilities/ Duties / Tasks

Managerial / Supervisory Responsibilities

• Supervise day to day operations in the unit
• Supervise, Coach and Mentor Staff

Operational Responsibilities / Tasks

• Ensure proper and accurate verification of invoices related to outpatient and inpatient medical claims and submit for data capturing in the iSupport system – Medical Module
• Ensure effective medical card management
• Pre-authorization and benefits adjustments in relation to medical benefits management
• Verify payments and deductions
• Ensures regulatory compliance with WIBA, labor laws
• Ensure relevant and related HR policies are understood and implemented consistently across the organization
• Facilitate identification and recommendation of medical service providers in the medical scheme
• Facilitate medical approvals in line with the medical policy
• Liaise with Finance division on payment matters
• Manage and implement medical management programs
• Communicate with Internal and External stakeholders
• Provide information, data, statistics and internal reports on medical issues for senior management considerations
• Implement medical management programs
• Day-to-day operations and supervision of staff in the unit
• Facilitate implementation of the work plans for the following corporate initiatives in the unit: Audit, Integrity, QMS and Risk Management.
• Drive initiatives to improve ethics, culture and facilitate change management in the unit

Job Dimensions:

Responsibility for Physical Assets

• Responsible for physical assets assigned by the institution.

Decision Making / Job Influence

• Make strategic, operational and financial decisions
• Plans the work of subordinates
• Assigns work to subordinates
• Monitors subordinates work performance
• Appraises/evaluates subordinates performance

Working Conditions

• Works predominantly in a comfortable environment/Office Setting

Job Competencies (Knowledge, Experience and Attributes / Skills).

      Academic qualifications

• A degree in Human Resource Management or related field from a recognized institution.

Professional Qualifications / Membership to professional bodies

• Diploma in HR/Post graduate Diploma in HR/ Certified Human Resource Professional (CHRP)
• Membership to a Professional Body – IHRM

Previous relevant work experience required.

• Minimum of 3 years work experience in a similar 

Functional Skills, Behavioral Competencies/Attributes:

• People management skills.
• Risk management and analysis.
• Results driven and analytical.
• Strong decision-making skills.
• Excellent communication skills.
• Good interpersonal skills.
• Technological ability.
• Tax business understanding.