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Job

General Manager, Medical Business - Kenya

Jubilee Insurance Ltd. was established as the first incorporated Insurance Company based in Mombasa in August 1937. They have since spread their wings and sphere of influence as the No. 1 Insurance Company in the region with offices in Kenya, Uganda, Tanzania, Burundi and Mauritius and are recognized as the largest Composite Insurer in East Africa with over 450,000 clients.

They are listed in the Nairobi Securities Exchange, Dar Es Salaam Stock Exchange and the Uganda Securities Exchange having been rated highly on Leadership, Quality and Risk Management and awarded AA- rating in Kenya & Uganda and an A+ in Tanzania. As of December 2016, Jubilee’s total asset base was KSH 90.6 Billion with a profit before tax of KSH 4.6 Billion.

Jubilee Insurance Company of Kenya, ahead of the expected changes in regulation, will be split into three separate companies - life insurance, medical insurance and general insurance, with each company having its own Head of Department.

The Role

This change has opened up a new role for a General Manager, Medical Business Kenya. The GM, Medical Business will be based in the Head Office in Nairobi, and will report to the CEO Jubilee Insurance Kenya. Their main purpose will be to;

  • Lead and manage all aspects of the medical  insurance business in Kenya to retain JICK's market leadership and underwriting profitability whilst building a best practice business platform and operating environment.
  • Provide Medical Insurance technical oversight, guidance and services to the Jubilee Holdings (JHL) medical operations in the region, including operational responsibility for Actisure, the JHL medical insurance IT platform

Responsibilities

Lead Business Strategy Management

  • Through leadership, personal commitment and cooperation with the Jubilee Insurance management team define and implement strategies to fulfill JICK's Strategic Objectives, financial plans and profitability objectives.
  • Establishing regional medical business strategic direction and standards in coordination with the JHL CEO and present overall medical business strategy and or performance to the Senior Management.
  • Take responsibility for budget preparation, analysis and communication to support the objectives set by the JHL and JICK CEO's.
  • Keeping JHL and JICK senior management advised and informed on key business developments and trends through high quality, informative monthly and quarterly reports utilizing business intelligence tools. In addition, monitoring business trends and performance to ensure quick response to deviations.
  • Improving and optimizing operational processes in JICK to maximize use of digital and electronic systems and tools and establish best in market service capabilities with strong automated internal controls and management level checks.
  • Oversee the development and constant review of comprehensive underwriting and claims guidelines that can be applied across the region
  • Exercising prudent financial control of the business, including rigorous expense management and control, with a clear focus on delivering sustainable, positive bottom line results
  • Lead the communication agenda of the business that ensures JHL Medical Business remains top of mind and an opinion leader on health insurance and related matters
  • Drive   innovation      through           technological   solutions         aimed  at            ensuring operational  efficiency         and      superior          customer experiences, including extension and enhancement of e-claims techniques and processes, including intelligent claims analysis and controls leading to the implementation of straight through processing techniques.

Drive Growth of the Medical Business

  • Establishing medical sales and marketing capacity and capabilities to drive the development of business with distinct channel management and sales/renewal objectives for corporate and retail business.
  • Setting standards and controls for quotations and business acceptance and ensuring that the authority limits are adhered to.
  • Establish product development processes to continually enhance product and service offerings across all segments and monitor profitability at product and channel level to enhance management decision making.
  • Ensure 90% retention and superior customer standards executed through relationship management and process efficiencies.
  • Oversee proper contract management of policy documents, third party administration contracts, service level agreements and other third party contracts.

Drive Profitability

  • Establish robust systems, controls and capabilities to ensure the effective and optimal claims process, including case and care management. This also includes a focus on wellness.
  • Managing the provider panel, provider panel rationalization and contracting of all providers to enable JHL to control cost of service and treatment whilst ensuring optimal medical outcomes for clients.
  • Driving provider costs negotiations and pharmacy agenda to ensure claims controls and adherence to agreed protocols.
  • Oversee fraud management and compliance to the controls instituted with ongoing review of areas of improvement and gaps in coordination with risk management, compliance and internal audit teams
  • Excess management and safeguard on exhaustion of member limits including instituting models of recovery
  • Third Party Fund Administration management and debt management of the same
  • Oversee prompt provider payments, reconciliation and sign-off.
  • Set targets for premium collection and coordinate with credit control functions to minimize outstanding premiums and ensure zero bad debts.
  • Oversee the electronic claims initiatives and biometric project roll outs.

Oversee Human Resource Management

  • Build the senior management team with the skills and capacity to meet JICK’s strategic objectives and create an environment that is adaptable and well-positioned to respond to dynamic market conditions.
  • Building the systems and human resource capabilities and training systems that will enable the business to successfully pursue the agreed strategies.
  • Developing employees to the standards required to meet strategic objectives and establishing robust succession planning for all key positions.
  • Ensuring maximum coordination, synergy and business knowledge transfer within the country and region.
  • Coaching, training, mentoring and succession planning of the medical team.

Oversee General Administration of the Medical Department

  • Ensuring effective and efficient operation of the department in all areas.
  • Representation of medical business at the Association of Medical Insurers.
  • Ensuring best business practices through full compliances on Know Your Client (KYC) and Anti Money Laundering (AML).
  • Development of risk management controls and guidelines through active participant in the development of JICK’s Risk Management policy, principles and framework.

Key Deliverables

Meet growth and distribution targets

  • Achieve medical underwriting profitability targets
  • Ensure effective and efficient operation of the department
  • Optimize process automation and digitization of claims and underwriting processes
  • Develop depth of management and technical capability and competence in the medical business

Key Indicators

Key Interfaces

Trading Result

Budget

Direct Reports (jobs)

Internal

External

GWP growth and targets by channel and product line: underwriting profit in line with assumed margins

TBA

Heads of Department and Medical Team, Kenya

All staff in the Medical Department, all other departments in the company and region

Clients, intermediaries, service providers, medical system partners, Association of Kenya Insurers (AKI), reinsurers and international partners interacting with the company.

 

Requirements

Academic Qualifications

  • B.Com or degree in any other Business or Health field.
  • Diploma/Advanced Diploma in professional insurance (ACII) would be an advantage.
  • Master’s Degree would be an added advantage

Key Competencies

  • Highest standards of integrity and ethical conduct.
  • Visionary leadership and entrepreneur spirit
  • Market awareness
  • Customer focus
  • System orientation
  • Continuous innovation
  • Ownership and commitment
  • Team spirit

Relevant Experience

  • Minimum of 7 years’ experience

Functional Skills

  • Performance reporting and management.
  • Accounting, operations
  • Health Benefits Plan Management
  • Policy Reinsurance Authorization
  • Intelligence and Business Development skills
  • Policy processing
  • Database administration
  • Exploitation and application of Information Technology
  • Customer service