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Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

Role purpose:

The Health navigation officer reporting to the Wellness lead will be key in the review of health trends across the various customer segments within the medical business, with an aim of designing programs/initiatives that promote high quality service delivery, cost effective benefit utilization and desired preventive/curative wellness and  business outcomes.

Key Responsibilities:

Execute designed wellness programs tailored to clients' needs, including fitness, nutrition, mental health, and stress management initiatives.Facilitate the adoption and utilization of Old Mutuals digital wellness platform by our customers to offer holistic wellness solutions and drive customer engagement.Roll out wellness awareness initiatives such as health literature, webinars, health talks and relevant events.Monitor health-seeking trends across our corporate and retail customer base with the aim of supporting clients in effective utilization of wellness-related benefits to promote overall population health/wellbeing and cost effectivenessAssist clients in navigating the healthcare system, including connecting them with appropriate healthcare providers and understanding their health benefits.Engage with customers and intermediaries on various forums to raise awareness and utilization of wellness initiatives and drive appropriate health behavior changeCollaborate with healthcare providers and wellness experts to offer accessible and affordable comprehensive wellness solutions.Monitor and analyze wellness program outcomes, preparing reports and recommendations for areas of improvement.Conduct workshops, seminars, and training sessions to educate clients and employees on wellness topics.Stay updated on industry trends and best practices in wellness and insurance.Monitor data to ensure healthcare utilization and desired outcomes are met.Ensure compliance with regulatory requirements related to wellness programs and insurance services.The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and its subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.

Qualifications:

Bachelor’s degree in health sciences, Insurance, or a related field.At least 2 years of experience in a clinical or digital health setting. Health insurance experience is an advantage.Strong interpersonal and communication skills.Experience in designing and managing wellness programs.Knowledge of insurance policies and wellness benefits.Proficiency in health navigation, including connecting clients to healthcare resources.Analytical skills to assess program effectiveness and make data-driven decisions.Proficiency in reporting across various stakeholder segments.

Skills:

Empathy and a client-focused approach.Exceptional health navigation skills to help clients understand and access healthcare services across our panel of providersAbility to work collaboratively across departments.Proficiency in Microsoft Office and wellness-related software tools.Problem-solving and organizational skills, a commitment to continuous improvement and quali6ty service delivery

Develop cost-effective care plans for high-risk, high-cost cases by working with healthcare providers, members, and their families. Manage specific, complex medical events of members to determine the appropriate standard of care. Identify and resolve complicated disputes of members, their families, and healthcare providers.

ResponsibilitiesContract Requirements

Identify contract requirements and write specifications for a small portfolio or area of the business for existing contracts and/or new contracts.

Contract Management

Deliver required outcomes by coordinating activities of subcontractors and suppliers and acting as a primary point of contact for them while working within an established contract management plan.

Cost Reduction

Lead cost reduction and cost saving projects, ensuring the review and implementation of cost reduction measures and maintaining quality standards.

Patient and Family Management

Carry out activities relating to patients and their families, and provide support to others. Help colleagues manage relationships with patients and families, using standard systems and protocols.

Resolving Customer Issues

Respond to more advanced issue escalations promptly and appropriately; provide managerial approvals as required.

Data Collection and Analysis

Collate and analyze data using preset tools, methods, and formats. Involves working independently.

Document Preparation

Organize and prepare complex documents using a variety of applications for technology devices, such as standard office software. Also responsible for gathering and summarizing data for special reports.

Operational Compliance

Develop knowledge and understanding of the organization's policies and procedures and of relevant regulatory codes and codes of conduct to ensure own work adheres to those standards. Obtain authorization from a supervisor or manager for any exceptions from mandatory procedure.

Personal Capability Building

Develop own capabilities by participating in assessment and development planning activities as well as formal and informal training and coaching. Develop and maintain an understanding of relevant technology, external regulation, and industry best practices through ongoing education, attending conferences, and reading specialist media.

Skills

Competencies

Action OrientedBusiness InsightCollaboratesCommunicates EffectivelyCourageCultivates InnovationCustomer FocusDecision Quality

Education

Closing Date

22 April 2025 , 23:59

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