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Team Leader – Business Development

Job Description

We are seeking a dynamic and experienced Team Leader to join our Corporate New Business Development team. The ideal candidate will be responsible for leading a team of Business Development Officers and driving the acquisition of new corporate clients for our organization.

KEY TASKS AND RESPONSIBILITIES

• Lead and manage a team of Business Development Executives to achieve set targets for acquiring new corporate clients.
• Develop and implement strategic plans to drive new business growth in line with the company’s objectives.
• Identify and prioritize target markets and industries for new client acquisition.
• Build and maintain strong relationships with potential clients through networking and proactive outreach.
• Monitor market trends, competitor activities, and industry developments to identify new opportunities for business growth.
• Provide regular reports on team performance, market trends, and client feedback to senior management.
• Provide guidance and leadership, direction, and support to the business development team.
• Set clear goals and objectives for team members and ensure they are aligned with the overall business strategy.
• Motivate and inspire team members to achieve targets through coaching, training, and mentorship.
• Work with senior management to develop business development strategies and plans that align with the company’s objectives.
• Identify new market opportunities, industries, or geographic regions for expansion.
• Lead by example by actively engaging in business development activities, such as prospecting, lead generation, and client meetings.
• Manage the sales pipeline, track progress, and ensure timely follow-up to close deals.
• Build and maintain strong relationships with existing clients and intermediaries to ensure satisfaction and loyalty.
• Develop partnerships and strategic alliances with key stakeholders i.e bancassurance, agents, brokers.
• Represent the company at industry events, conferences, and networking opportunities to expand the business network.
• Monitor team performance against KPIs and sales targets.
• Provide regular reports to senior management on business development activities, progress, and results.
• Identify areas for improvement and implement corrective actions as needed to optimize team performance.
• Collaborate with other departments, such as marketing, product development, and customer support, to ensure alignment and coordination in business development efforts.
• Provide input into product or service development based on market feedback and client needs.
• Stay updated on industry trends, best practices, and emerging technologies related to business development.
• Encourage ongoing learning and skill development within the team through training programs, workshops, and professional development opportunities.
• Ensure compliance with relevant regulations, policies, and ethical standards in all business development activities.
• Identify and mitigate potential risks related to business expansion, client relationships, or market dynamics.
• Collaborate with internal teams to develop customized solutions for clients and ensure smooth onboarding processes.

SKILLS AND COMPETENCIES

Competences

• Excellent communication and interpersonal skills.
• Ability to think strategically and drive results.
• Experience in developing and implementing sales strategies.
• Knowledge of market research and analysis techniques.
• Ability to thrive in a fast-paced and dynamic environment.

Qualifications

• Bachelor’s degree in business administration, Marketing, or related field.
• Proven experience in business development, sales, or a related field – 3 years minimum
• Demonstrate progress towards achieving insurance professional qualification.
• Strong leadership and team management skills.

Team Leader – Business Retention

Job Description

As a Team Leader – Business Retention, you will be responsible for overseeing a team of Relationship Managers and ensuring the successful retention and satisfaction of our client base. You will work closely with the sales and customer service teams to develop strategies for maintaining long-term relationships with key clients and intermediaries, identifying opportunities for upselling and cross-selling, and resolving any issues or concerns that may arise.

KEY TASKS AND RESPONSIBILITIES

• Lead and manage a team of Relationship Managers, providing guidance, support, and mentorship to help them achieve their retention targets.
• Develop and implement strategies to retain and grow the client base, including upselling and cross-selling opportunities.
• Managing the workflow and distribution of tasks within the retention team to ensure efficient handling of customer inquiries, requests, and retention efforts. This involves prioritizing tasks, assigning workloads, and optimizing team resources to meet retention goals.
• Implementing quality assurance measures to ensure that retention team members adhere to company policies, procedures, and regulatory requirements, may conduct regular audits of calls or interactions to assess compliance and identify areas for improvement.
• Monitor key performance indicators (KPIs) and metrics to assess team performance such as persistency, policy renewal rates, and customer satisfaction scores, recommend solutions to improve customer experience.
• Collaborate with sales, customer service, and other departments to ensure seamless client experience and address any client concerns or issues in a timely manner.
• Analyze client feedback and data to identify trends and opportunities for enhancing the client retention process.
• Prepare regular reports and updates on team performance, client retention rates, and other relevant metrics for senior management.
• Customer Engagement: Engaging with existing customers to foster a sense of loyalty and satisfaction is crucial. Oversee initiatives such as customer feedback surveys, personalized communications, and outreach programs to ensure customers feel valued and supported.
• Develop customer segmentation strategies to improve customer experience.
• Ensuring that all retention strategies and activities comply with industry regulations and ethical standards. This includes adhering to data privacy laws, transparency in communications, and fair treatment of customers.
• Working closely with other departments such as marketing, sales, underwriting, and claims to ensure a cohesive approach to customer retention. This involves sharing insights, coordinating efforts, and aligning strategies to optimize customer retention efforts across the organization.
• Training and Development of intermediaries and internally staff so that they have the necessary skills and knowledge to effectively retain customers. This may involve providing training sessions, resources, and guidance on best practices for customer retention.
• To works to mitigate risks by addressing customer concerns, resolving issues promptly, and ensuring that policy terms and conditions meet customer expectations.
• Developing Retention Strategies: Based on the analysis of customer data, one devises and implements strategies to improve customer retention. This could involve developing targeted marketing campaigns, loyalty programs, or incentives for policyholders to renew their policies.
• Continuous Improvement: Proactively seeking opportunities for process improvement and innovation to enhance the effectiveness of retention strategies and the overall customer experience, implements changes based on feedback, industry best practices, and emerging trends.
• Handling escalated customer issues or complaints that require supervisor intervention. The Retention Supervisor acts as a point of contact for unresolved customer concerns, providing resolutions and ensuring a high level of customer satisfaction.
• Negotiating with customers to renew contracts and retain business.
• Daily monitoring of the customer complaints registers to ensure constant update and timely resolution whilst compiling feedback on recurrent issues for management information use.
• Guide the team to develop a professional work ethic and motivate staff by ensuring that they are properly and promptly recognized.

SKILLS AND COMPETENCIES

Competences

• Strong leadership and team management skills, with the ability to motivate and inspire team members to achieve their goals.
• Excellent communication and interpersonal skills, with the ability to build and maintain relationships with clients and internal stakeholders.
• Analytical mindset with the ability to interpret data and trends to drive strategic decision-making.
• Ability to thrive in a fast-paced and dynamic environment, with a strong focus on results and client satisfaction.
• Capacity to prioritize tasks, manage time effectively, and coordinate team activities to ensure efficient and productive workflow.

Qualifications

• Bachelor’s degree in business administration, Marketing, or a related field.
• Above 5 years’ experience in business retention or account management
• Demonstrate progress towards attaining insurance professional qualification

Supervisor – Retail Retention & Operations

Job Description

Reporting to the Underwriting Manager, Health, this role serves to provide clinical support aimed at maintaining a profitable and efficient retail health insurance portfolio.

The key tasks assigned to this role include:

• Continuously reinforcing and implementing experience-based underwriting discipline.
• Providing flexibility in offering tailor-made retail client solutions, with adequate pricing controls in place.
• Providing technical support to the retention and business development teams in pricing discussions and ensuring accurate quoting for SME schemes and retail policies.
• Reviewing performance by product on a quarterly basis to monitor trends.
• Ensuring that policy wordings remain full-proof, clear and free of subjectivity.
• Evaluating the quality of existing data sources to ensure accuracy, completeness, and consistency.
• Continuously researching on health trends that the business should look out for when accepting new policies.
• Recommending product adjustments necessary to match the changing clinical needs of the retail and SME clients to ensure that products remain competitive.
• Implementing feedback loops to continuously improve the efficiency of the enrolment and renewal process.
• Leveraging statistical analysis to identify patterns and trends within the data to provide insight to support decision making at various levels within the business.
• Performing scenario analysis to assess the impact of different factors on underwriting and claims decision-making.
• Proposing enhancements to the insurance products and services to improve the overall customer experience.
• Carrying out intermediary and scheme-based monthly reporting to flag the poorly performing entities and propose remedial actions for them.
• Conducting research and supporting development of business cases for new and revamped products from a clinical perspective.
• Recommend health interventions to the insured members based on observed claiming trends.
• Ensure that products remain up to date with clinical best-practice global health insurance trends.
• Training staff and supporting launch to market of new and revamped products.
• Providing clinical support to potential strategic business partnerships.

Qualifications

• University degree in an insurance, finance or health related field.
• Have a valid membership of the relevant professional entity eg Nursing council.
• At least 3 years’ experience in retail underwriting.
• Have clinical background – Nursing/Clinical Officer
• Experience in leading a team.
• Professional qualification in insurance or significant progress in attaining an insurance qualification.

Quality Assurance Officer – Health

Job Description

The Health Insurance QA Officer is responsible for ensuring the accuracy and compliance of health insurance claims processing within the organization. This role involves reviewing claims, identifying errors or issues, and implementing corrective actions to improve quality assurance processes.

KEY TASKS AND RESPONSIBILITIES

Quality Audits Of Claims.

• Identify Providers with significant billing irregularities or suspected of fraud and have regular provider engagement issues on billing.
• Review claims that relate to benefit excesses, assign liability, and recover while ensuring the root cause is addressed.
• Admissions tracking; checking on exaggerated bills, unnecessary admissions or overstay admissions, and doctors’ charges.
• Review system rejections of claims for root causing and resolution.
• Quality audits on the vetters and ML module to identify quality gaps and remediate them.
• Identify and investigate any errors, discrepancies, or quality issues in the claims processing procedure
• Collaborate with various departments (e.g. underwriting, provider relations, IT) to resolve complex claims issues

Reporting and Trend Analysis.

• Prepare objective reports on processes that lead to leakages and proposed mitigative measures.
• Review claims, and provide recommendations to claims, retention, case, and provider relations teams on trends noted: both from users and providers.
• Make recommendations to management regarding developing policies, processes, and procedures; identify and implement processing efficiencies; identify trends and continuing education opportunities.
• Manage reserve philosophy for admission/approved and or enhanced amounts through weekly audits to ensure the acceptable threshold is being met.
• Review reimbursement reports to pick exceptions and cold calling/impromptu visits to validate.
• Conduct regular process audits to enforce adherence to laid out SOPs across the health business
• Maintain proper documentation of call performance and associated corrective measures as applicable

Training and Feedback

• Designing effective training programs and collaborating with trainers to ensure the feedback loop from the QA audits is complete.
• Identify knowledge gaps and training needs of the relevant teams and hold calibration sessions and breakout training sessions as needed.
• Develop and implement quality control measures to prevent future errors and improve efficiency
• Stay up-to-date with changes in healthcare laws, regulations, and best practices related to claims management

Monitor and support risk management activities: GIA issues

• Prepare regular claims reports to management and advise on relevant claims findings for medical risk review.
• Ensure all audit items are closed in your respective area.

Systems Enhancement

• Continuously review the effectiveness of workflow systems and recommend enhancements.
• Provide input on ML and core system enhancements to improve quality and output.

Any other tasks/duty as may be assigned by the Line manager.

SKILLS AND COMPETENCIES

Competences

• Proficiency with claims management software and data analysis tools
• Motivated team player who is detail-oriented.
• Excellent communication skills, both written and verbal 
• Strong working knowledge of the Microsoft suite of products 
• Strong analytical, problem-solving and decision-making abilities.

Qualifications & Requirements

• 3+ years experience in Quality Assurance/Medical claims/Case management
• Bachelor’s Degree or Diploma in Nursing/Clinical Medicine
• Experience working in the Insurance industry preferred.
• Additional insurance qualifications will be an added advantage

Case Management Nurse

Job Description

To control and manage medical benefit utilization through preauthorization and case management activities and ensure quality, appropriate cost-effective care and good customer service

KEY TASKS AND RESPONSIBILITIES

• Pre-authorize scheduled and non-scheduled admissions within the set guidelines.
• Negotiate/discuss professional fees as appropriate for each admission.
• Set the appropriate parameters for each admission (claim reserve, initial authorized cost and duration).
• Visit all admitted clients within Nairobi region and its environs
• Liaise with Doctors on the day-to-day management of patients and obtain medical reports/ expected length of stay where indicated.
• Ensure smooth discharge process and co-ordinate any necessary post-hospitalization/ step down facility care.
• Revise reserves after discharge of member.
• Collect feedback from admitted clients on quality and scope of service by the service provider.
• Assist in carrying out verification and medical audit of claims/invoices before settlement.
• Develop and maintain monthly database on admissions, large claims and extended length of stay. 
• Respond to queries from clients, intermediaries and service providers.
• Liaise with other medical underwriter for purposes of market surveys and development of new controls, standards and products.
• Any other duty assigned by management.

SKILLS AND COMPETENCIES

• Excellent communication and negotiation skills.
• Excellent public relations and interpersonal relationship skills.
• Extensive networking with SP and other medical insurers.
• Excellent analytical and monitoring skills
• Good IT skills in database management and office systems.
• Good decision making in benefit utilization management.
•  High levels of integrity and honesty

QUALIFICATIONS, KNOWLEDGE & EXPERIENCE

• Diploma or Degree in Nursing                     
• Diploma in Insurance/ COP
• Degree in Health systems Management/ Business management 
• 3 years’ experience in clinical setting +2 years in insurance set up

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