Medical Scheme Key Relationship Manager: Member Services

Together with our client in Pretoria, we are recruiting for a Key Relationship Manager who should manage the implementation of member experience strategy to deliver member delight at each touchpoint with the scheme through effectively leading and guiding a team of member liaison officers. The Ideal Candidate needs to have 6 years’ Marketing, Customer Service, or Wellness Management experience at a medical scheme and an NQF Level 7 Degree qualification in Marketing or Commerce.

Duties and Responsibilities

Member service excellence

• Analyses member data to generate insights, identify gaps in member service processes, and address gaps with the Administrator / MCO;
• Analyses member interaction trends across all touchpoints to identify themes for assigned regions and liaises with the Administrator / MCO for root cause analysis and course correction.
• Monitors efficiency of the call center, walk-in centers, or regional offices;
• Monitor member queries and complaints to the Council of Medical Schemes (CMS) and develop strategies to minimize and mitigate these.
• Facilitates prompt issue and query resolution for escalations from members in the region.

Member communication

• Drafts member communication plan for designated region;
• Executes communication in the designated region per member communication plan;
• Undertakes education campaigns on scheme processes, products, benefits, healthcare provision, wellness, and preventative benefits
• Tracks performance of member communication to ensure effectiveness and continuous improvement; and
• Ongoing engagement with outsourcing partners to ensure alignment of member communication delivery.

Health Promotion

• Analyses data and generates insights on key health trends impacting on members in designated regions;
• Packages and delivers health promotion campaigns for specific regions - including peer education, information dissemination, targeted events and initiatives to raise awareness of good health, diet, and exercise;

Key Relationship Manager: Member Services

• Undertakes campaigns to promote uptake on preventative care benefits and monitors and tracks progress; and
• Supports delivery of wellness interventions through planned events and activations in specific regions.

Stakeholder Management

• Develops effective stakeholder relationships with SAPS for effective execution of wellness programs for the improvement of health outcomes;
• Creates strong relationships with MCO team to identify opportunities for improving health outcomes through wellness interventions;
• Create a strong relationship with Pharmacy Partners;
• Develops and implements an effective stakeholder engagement plan; and
• Provide regular feedback on progress and highlight or escalate snags and problems immediately as they occur.

People Management

• Manages member liaison officers in the region and implement performance and talent management;
• Oversees effective utilization of systems and tools to ensure that knowledge is managed efficiently for continuous improvement;
• Makes recommendations to Senior Manager for the reward of high performing members; respects promotes and accepts diversity; and
• Coordinate and facilitate regular training of direct reports in order to ensure the application of processes and SOPs.

Compliance and Governance

• Executes in adherence to all relevant regulatory and business practices;
• Active risk management by applying and promoting a culture of ongoing detection and resolution of Statutory, Regulatory Compliance breaches; and
• Contributes to a high-performance corporate culture that promotes ethical practices and encourages individual integrity, accountability, and social responsibility.

Financial Management

• Inputs into budgeting and implements associated control measures;
• Maximize resources to optimize people capabilities;
• Ensure adherence to approved budget;
• Manage and monitor budget through managing variances in actual vs. budget expenditure in all areas of accountability; and
• Develop and implement measures to improve the functional area’s cost management.

Culture: Live and exemplify the client’s values

Skills and Competencies

• People management
• Customer service strategic awareness and trend analysis
• Strong administration
• Interpersonal skills
• Awareness of sensitivities of different stakeholders
• Ability to work well in a multi-cultural environment
• Collaboration
• Change Management
• Mentoring & Coaching experience
• Planning & Evaluation skills
• Analytical skills
• Business Report Writing, communication, and presentation skills
• Complex problem-solving skills (potential conflicting priorities)
• Organisational skills (planning, budgeting, work-prioritization, time-management, etc)
• Diplomatic (creating win-win solutions)
• Results and performance-driven
• Financial and Project Management skills
• Sound judgment
• Delegation

Required Minimum Qualifications

• NQF Level 7 Degree qualification in Marketing or Commerce (specialization in marketing/customer relationship management or customer service)
• Coaching, Facilitator or Train-the-trainer certification; and Wellness, Stress management, nutrition, fitness, and mental-emotional wellbeing training as an added advantage
• 6 years’ experience in Marketing, Customer Service, or Wellness Management in medical schemes
• 4 years supervisory experience
• Demonstrate deep knowledge of customer care, communication or wellness

Salary: Market Related

Benefits: Medical Aid, Provident and Pension Fund

Only candidates who meet all the requirements stipulated in this advert, will be considered. If you don’t receive feedback from us within 2 weeks of your application, please consider your application as unsuccessful.

To apply please send your CV and supporting documents to with REF: Key Relationship

Closing date: 25 March 2022