ROLE PURPOSE

 

Accountable for developing, enhancing and sustaining long-term relationships with a portfolio of clients to drive member retention and growth strategies, delivering an exceptional customer service, to enable the Scheme to achieve its strategic objectives.

 

Key Responsibilities


Functional Management

  • Build and maintain professional relationships with employer groups to support member growth and retention.
  • Provide guidance, advocacy and administrative support to prospective and existing members on Scheme benefits, contributions and processes.
  • Manage, investigate and resolve stakeholder queries professionally, escalating where necessary.
  • Serve as the first point of escalation and coordinate solutions with internal teams and service providers.
  • Prepare accurate quarterly and annual Employer Group Reports for presentations.
  • Support new business events, campaigns and key year-end initiatives.
  • Identify process, service and quality improvement opportunities based on stakeholder feedback.
  • Collaborate with internal divisions to resolve member, broker, provider and stakeholder queries.
  • Maintain updated knowledge of the medical scheme industry, benefits and product offerings.
  • Own reliable vehicle required
  • Travel for business is a requirement for this role.

Risk & Compliance Management

  • Apply fraud controls, risk-prevention measures and sound governance principles.
  • Support internal, external and ISO audit requirements by providing accurate information.
  • Maintain compliance with quality and service standards aligned to ISO protocols.
  • Enforce SLAs to reduce operational risk and support business continuity.
  • Contribute to the development and enhancement of Standard Operating Procedures.
  • Ensure adherence to all relevant legislation, policies and organisational procedures.

Stakeholder Management

  • Build and maintain strong internal and external stakeholder relationships to support service excellence and expectations management.
  • Provide support to business units where cross-functional collaboration is required to achieve organisational outcomes.

EXPERIENCE

QUALIFICATION

  • 2 Years Sales/Portfolio Management
  • 6 Years in the Medical Aid industry
  • 2 years in corporate account management or sales in medical schemes
  • 2 years minimum Retentions management
  • 2 years minimum Corporate Account management
  • Minimum 5 years working experience in a medical Scheme/Medical Administrator
  • Technical knowledge 5 years of NEXUS system experience
  • Diploma in Sales/Marketing or Business Administration (NQF Level 6)
  • RE5 (Advantageous)

Knowledge

Skills

Attributes

  • Relevant legislation and regulatory frameworks
  • Risk Management practices and principles
  • Key Account Management
  • Business acumen
  • Technical problem solving
  • Claims Assessing
  • Annexures and Scheme rules
  •  
  • Verbal and Written Communication
  • Conflict management
  • Microsoft office
  • Negotiation
  • Computer literacy
  • Resilience
  • Detail Orientation
  • Innovative Thinking
  • Customer Centric
  • Results Focused
  • Quality Focused
  • Compliance Driven
  • Analytical Thinking
  • Problem Solving
  • Assertiveness
  • Confidentiality
  • Active Listening
  • Emotional Maturity

 

 

 
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