CHIEF OPERATIONS OFFICER

Job Title: Chief Operating Officer (COO)

Reporting To: Principal Officer

Employment Type: Fixed term contract / Consulting Contract

Purpose Of The Position:
The role of the Chief Operations Officer (COO) is to provide strategic leadership and direction to the scheme's operations portfolio, oversee the execution of the strategic objectives, make the most cost-effective healthcare systems available and accessible to members and ensure efficiencies of scheme operations.

Duties And Responsibilities:

• Provide visionary leadership to the overall operations of the scheme ensuring that all divisions and employees reporting to this role operate efficiently, enabling achievement of the scheme strategic objectives.
• Oversee the scheme's operation and administration in an innovative and cost-effective manner.
• Provide support to the Principal Officer with particular emphasis on achieving business efficiency and savings, while improving productivity within all aspects of operations, including financial and healthcare performance.
• Identify and manage strategic operations projects.
• Provide input, develop, execute, and monitor the scheme's overall strategy.
• Manage and oversee the operational budget.
• Ensure fit and proper governance and risk management of the operational department; as well as ensure accurate reporting.
• Develop, implement, and measure overall effectiveness and efficiency of processes; whilst ensuring compliance with relevant regulations and mitigate risks.
• Ensure optimal collaborations between the scheme, the employer, and the fund administrator.
• Have a strong understanding of NHI and align with the employer's health strategy.
• Provide data insights that impact the strategic direction of the scheme.
• Provide operational insights to ensure alignment with all regulatory and legislative requirements.
• Ensure that the scheme rules remain relevant while enabling scheme strategy.
• Contribute to the development and achievement of the scheme's overall strategy.
• Ensure collaboration with relevant governance structures, including BoT and sub-committees.
• Develop, implement, and maintain benefit structures.
• Design benefit structures to address scheme risks.
• Develop a practical and effective service provider network.
• Determine programme design measures and financial rewards.
• Monitor and maintain provider contracts and relationships.
• Develop and implement scheme strategy to expand the network.
• Design, develop, and implement a focused managed health care programme.
• Identify and manage scheme cost drivers.
• Conduct in-depth scheme utilization analysis.
• Negotiate service level agreements and develop contracting model.
• Review current contracts and develop negotiating strategy tactics.
• Design, develop, and implement organisational developments that align scheme and employer.
• Manage operational model of primary health care centres, with an in-depth analysis of centre utilisation.
• Develop, implement, and maintain member wellness and education strategy.
• Develop and analyse member surveys.
• Mentor and manage direct reports.
• Mentor, manage, develop, and drive accountability within the team through effective implementation of performance management.

• MBCHB degree or equivalent in Health-related field.
• A post-graduate business degree would be an added advantage.

• 8 to 10 years of experience in the health industry.
• 4 to 6 years executive management experience.
• Proven track record of innovation, delivery, and performance in medical scheme operations, systems, administration, and services is essential.
• Experience in scheme administration would be an added advantage.

• Physician relationship management
• Clinical Risk Management
• Project Management
• Account Management
• Adaptability/Flexibility
• Excellent communication skills
• Customer Focus
• People Management
• Product Knowledge
• Result driven
• Team leadership
• Territory management
• Travel required, own vehicle and valid driver's license essential.

This job specification should not be construed to imply that these requirements are the exclusive criteria/duties of the position. Preference will be given to Employment Equity candidates.

• MEDICAL
• OPERATIONS