Key Responsibilities<\/p>\n
Principle Accountabilities for this role include, but not limited to the following:<\/p>\n
Contributions Management (40% Weight)<\/p>\n
\u00a0Ensure all employers are compliant with contributions in line with the NHI Act.
\nEnsure timely payment of contributions by employers.
\nEnsure all member accounts are updated with contributions and in active status.
\nTake stock of all noncompliant employers and initiate inspections to establish outstanding debt.
\nWhere necessary trigger inspections in corroboration with the inspections team on the defaulting employers.
\nProvide monthly contributions reports\/trends to inform next course of actions
\nActively monitor compliance and ensure to stay within desirable rate.
\nAct as primary operational contact for public sector employers on contribution matters
\nSupport audits, reporting, and compliance reviews related to contributions<\/p>\n
2. Member & Employer Data Management (30% Weight)<\/p>\n
\u00a0Ensure accurate classification of members and Employers in accordance with updated business rules and statutory requirements.
\nEnsure accurate member personal data under the portfolio.
\nEnsure all enrollment activities comply with set criteria and quality standards.
\nEnsure timely and accurate updates of principal and beneficiary information in the system.
\nConduct periodic audits of registration (Current &Historical) records to confirm accuracy and completeness.<\/p>\n
3. Member Guidance & Support (10% Weight)<\/p>\n
\u00a0Provide guidance to principal members and beneficiaries regarding policy entitlements, benefit access, contribution requirements, and claims-related inquiries.
\nResolve escalated membership issues and ensure timely communication with members.
\nKeep a record of recurring membership issues with a view of implementing a permanent solution.<\/p>\n
4. Collaboration & Issue Resolution (10% Weight)<\/p>\n
Collaborate with Claims, Provider Relations, Finance, and Compliance units to resolve discrepancies affecting member service delivery.
\nParticipate in cross-functional committees or task forces addressing membership and data integrity.<\/p>\n
5. Staff Management (Weight 10% Weight)<\/p>\n
Supervise officers under public sector portfolio and quality-check their work
\nOverseeing staff daily operations and guide their performance
\n\u202fEnsuring staff adherence to company policies and quality standards to ensure\u00a0 team productivity and development<\/p>\n
\u00a0
\n\u00a0<\/p>\n
Education Requirements<\/p>\n
Grade twelve (12) School certificate with 5 \u2018O\u2019 levels with credit or better including Mathematics and English Language (ZAQA Certified)<\/p>\n
Health\u00a0Insurance, or any Social Security related qualification will be an added advantage.
\nBachelor\u2019s Degree in Social Sciences, Business Administration, Insurance, or related field (ZAQA certified).<\/p>\n
Required Skills<\/p>\n
5years of experience in a similar role in an insurance or Social Security industry.
\nStrong commercial acumen and operational experience with good understanding of current and emerging issues relevant to Health Insurance Industry.
\nRefined understanding of Zambian Legal and Regulatory framework surrounding Health Insurance Services.
\nAbility to positively influence Senior and Executive Management.
\nMust have strong influencing and negotiation skills.
\nExcellent knowledge of marketing and customer service.
\nMust have good interpersonal skills.
\nGood oral and written communication skills.
\nAttention to detail and excellent analytical skills.
\nGood appreciation of MS Office applications.<\/p>\n
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