Assistant Executive Director-Insurance

Job Summary

The purpose of this role is to ensure an accurate, well-coordinated and efficient implementation of insurance operations. Support in the provision of relevant and timely information and reports to the senior leadership to facilitate decision making and performance monitoring processes. Support in setting the business control framework, workflow procedures, processes and guidelines for the department and take responsibility for all Insurance processes and information externally; and provide guidance on, and approval to, the interpretation of the relevant insurance policies and regulations within their area of expertise and responsibility.

Key Accountabilities

• Designs, updates, and implements policies, procedures, controls, and protocols to ensure efficiency and accuracy in insurance operations while managing functions of sections under own administration.
• Contribute towards the formulation of strategy, annual business plans, policies, and procedures of division.
• Collaborate with senior leadership to align insurance strategies with the overall organizational objectives and support the strategic direction of the organization in implementing health insurance mandates.
• Drive the departmental plans and operations towards achievement of Departmental targets and objectives.
• Oversee provision of timely and accurate information to the external and internal auditors as and when required.
• Ensure that insurance claims are processed in a timely manner and resolve issues that arise during process.
• Follow up and negotiate with Insurance Companies where needed to ensure approval of problematic cases.
• Design and implement operational workflows compliant with regulatory standards and proactively identify areas of risk in the insurance implementation process and develop mitigation or alternate plans.
• Organize and manage team development and training activities to educate staff of legal, procedural, and organizational compatibility of Insurance procedures and processes.
• Identify threats to data security and implement controls to ensure no breeches and cybersecurity threats to sensitive patient information.
• Ensure high standard of confidentiality to safeguard commercial sensitive information.
• Perform other duties as assigned.

Education

Any Healthcare degree

Experience

8 years’ experience in Insurance in Healthcare Facility OR Healthcare Insurance Company

Bilingual preferred.