Head of Operation at Best Search Recruitment

Best Search Recruitment is a partnership based company of highly experienced international recruiters with over 20 years industry experience. Our consultants are focused on locating hard to find talented individuals for reputable companies world wide.

We are recruiting to fill the position of:

Job Title: Head of Operation

Industry: Health Insurance
Level: Senior Management
Reports to: COO
Location: Lagos

Purpose of the Job

• The purpose of this role is to ensure that the company delivers stress free access to the benefits/care promised to its enrolees at reasonable and customary cost and at the same time is also able to generate industry best practice operating surplus.
• In short, this role will ensure that the company is able to live up to its mission of “delivering stress free access to great care” to all its enrolees at all times.
• The position will require an individual who will champion and deliver on the core values of the company, deliver all targets and KPIs, and provide strong and dynamic leadership for their business unit through coordinated effort. The individual will take the strategic lead for services in their business unit.

Responsibilities
The role will be responsible for and oversee:

• Pricing (premium rates for our customers and also tariffs for the providers) and underwriting controls to ensure that the underwriting surplus is in line with the strategic plan and annual budgets
• Effective data and IT platform management in order to produce consistent information across the organization.
• Fulfilment - enrolment and effective on-boarding of clients and enrolees.
• Access to care:
  • Timely and effective transmission of capitation and enrolees’ eligibility to providers.
  • Issuing of pre-authorizations (PAs) and control thereof.
  • Processing and settling claims from providers and also refund to enrolees.
• Customer service - ensuring that the rational expectations of the customer (Client/Enrolees/Providers) are consistently met for the above the functions.

For the purpose of the execution of the above responsibilities, the person shall:

• Develop Operational Models to support better management reporting, information flow and management, business process and organizational planning.
• Prepare and effectively manage annual operational budget and long-term plans and report accurately on progress made and challenges encountered. He/She must be able to identify and explain variances between budget and actual experience.
• Streamline the processes and build standard operating procedures for each process in line with the objective of delivering superior customer service and get the same integrated with the IT systems.
• Develop negotiating strategies and positions vis-a-vis company strategies and operations; examining risks and potentials; estimating partners' needs and goals and consistently delivering the same.
• Stay appropriately networked and keeps abreast of trends, news, events and deadlines, so that all new or enhanced opportunities are exploited and risks mitigated.

KPI's:

• Underwriting surplus and margin (Revenue less Medical Cost less Other Direct Costs like Commission)
• Net Promoter Score of Enrolees, Clients and healthcare providers.
• Strategy score card - execution of strategy.

Qualification & Experience

• First degree in Medicine, Insurance, Social Sciences, or Business Administration. Possession of MBA or postgraduate degree in any management field, Health Financing or Managed Care is a plus.
• Professional qualifications in insurance will be an advantage.
• Minimum of 8 to 10 years of successful and proven work experience in similar or identical operations. At least three (3) of the years should be in a senior management role in managed care function with responsibilities similar to this JD.
• Proven healthcare management credentials, rapport building, and networking and relationship management, negotiation and conflict management skills.
• Entrepreneurial drive, passion and ability to multi task. The position requires an individual with high level of integrity and must possess leadership and problem solving skill. It is expected that he/she builds a professional and trusting relationship with all clients.
• Detail oriented, Can-do, positive attitude.
• Proficient communication, negotiation and presentation skills.
• Superior time management and organizational skills.
• Commitment to professional development.

Application Closing Date
Not Specified.

How to Apply
Interested and qualified candidate should:
Click here to apply online