Consultant Care Management (Mombasa) at Zamara
This role will be based in Mombasa, Kenya.
ABOUT ZAMARA
The Zamara Group is a diversified financial services
business specialising in pensions, medical services, insurance and actuarial
solutions. Headquartered in Nairobi, Kenya, the Group has a presence in eight
countries and a Pan-African ambition. Zamara has a rich heritage in Kenya
spanning over 30 years.
Since its inception, the firm has significantly grown in
terms of size, client base and range of services. The Group has been at the
forefront of industry, influencing the way it works and at the cutting edge of
innovation.
Zamara’s higher purpose is to create a financially secure
and prosperous society. The Zamara culture is based on the values of Simplicity, Empathy
and Trust.
ABOUT THE ROLE
Achieving Zamara’s ambitious strategic priorities will be
complex and challenging. Its continued success will be dependent on building
and retaining a world-class team.
The Assistant Consultant will ascertain seamless service
delivery to clients by offering support and assistance to medical insurance
policy holders through the claims & call centre and at medical facilities,
with minimal inconvenience, while supporting the overall goal of client
satisfaction.
KEY ROLES AND RESPONSIBILITIES
Care Management
- Manning
calls on the 24-hour medical emergencies help lines
- Facilitate
approval and authorisation for Emergency Inpatient hospitalisation e.g.
post road traffic accidents from the insurance companies/underwriters.
- Outpatient
treatment authorisation (off smart/ no card)
- Facilitate
evacuation processes to ensure favourable outcomes and reasonable charge
to clients.
- Preauthorization
request processing and hospital procedure booking including maternity and
theatre procedure bookings.
- Liaising
with the Insurance companies in the process of undertaking and
pre-authorizations.
- Provider
panel management – ensuring required facilities are onboarded and
favourable relationship is always maintained.
- Advocating
for clients
- Negotiation
of borderline claims
- Support
with overseas referral
- Offer
dedicated services to clients at their premises.
Reporting
- Provide
data reports collected from various monitoring tools assigned to the role
e.g. weekly and/or monthly reports.
- Trend
analysis – hospital charges, cost of various packages etc
Value Adds
- Facilitation
of admission and discharge processes for patients by securing all
necessary documents and ensuring minimal participation by the patient
during the admission or discharge.
- Facilitation
of special care for admitted patients e.g haircuts for executive clients
at the bed side/ flowers.
- Issuing
Zamara gift packs – pack of diapers, branded get well / birth
congratulations to admitted patients.
SKILLS AND QUALIFICATIONS
- A
Diploma in Nursing Sciences/ Clinical medicine
- Minimum
of one (1) year working in a hospital set up/ health facility/medical
insurance care department
- General
understanding of the insurance industry is an added advantage.
- Capacity
to build relationships
- Business
etiquette
- Excellent
interpersonal and customer service skills
- Team
player
- Problem
Solving skills
- Self-Driven
- Flexible
to train
ACTUARIAL GRADUATE TRAINEE VACANCY AT ZAMARA GROUP
The Zamara Group is a diversified financial services
business specialising in pensions, medical services, insurance and actuarial
solutions. Headquartered in Nairobi, Kenya, the Group has a presence in eight
countries and a Pan-African ambition. Zamara has a rich heritage in Kenya
spanning over 30 years. Since its inception, the firm has significantly grown
in terms of size, client base and range of services. The Group has been at the
forefront of industry, influencing the way it works and at the cutting edge of
innovation. Zamara’s higher purpose is to create a financially secure and
prosperous society. The Zamara culture is based on the values of Simplicity,
Empathy and Trust.
Roles and responsibilities
Achieving Zamara’s ambitious strategic priorities will be
complex and challenging. Its continued success will be dependent on building
and retaining a world-class team.
The Graduate Trainee will provide support to the Actuarial team in all aspects
of actuarial consultancy services.
In more detail, the areas of responsibility include:
Actuarial Valuations & Calculations
• Prepare calculations for checking by Senior Analyst and ensure deadlines are adhered to.• Carry out data checks/analysis for valuations and financial reviews.
• Draft valuation reports to be checked by Senior Analyst.
• Prepare individual calculations and ensure they are done according to the trust deed & rules and are within the accepted turnaround times.
• Ensure work is done in line with the quality control procedures.
Client Relations
• Occasionally communicate with clients to request for information or seek clarification with regard to data received.• Accompany senior team members to meetings.
Professional Development
• Learn and understand the processes/procedures & systems used for individual calculations and valuations.• Develop technical knowledge through formal on the job training.
• Identify potential process improvements and other inefficiencies and escalate to senior resources.
• Take on R&D initiatives under guidance of Senior Analyst.
• Assist team to contribute to the actuarial profession in Kenya.
Experience and personal qualities
Must Have Qualifications
- Bachelor’s
degree in actuarial science
- Graduated
within the past 2 years with a Second-Class Upper Division or above
- Mean Grade of B+ or above in KCSE or its equivalent
The following personal qualities are preferred:
- MS
Office with focus on Excel Skills
- Build
knowledge of Insurance/Pensions Industry
- Basic
actuarial mathematics
- Analytical
skills
- Results
oriented
- Excellent
oral and written communication skills
- Responsible
and accountable
- Time
management
- Accuracy
and attention to detail