Job Description

Introduction

Momentum Health Solutions, an entity of Momentum Metropolitan Holdings delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.

Disclaimer

As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose

The Head of Health Risk Management's mission is to lead the health risk management efforts of the company to ensure the overall health and well-being of covered lives, while maintaining regulatory compliance and financial sustainability. The position provides direction and leadership to ensure the Company meets the quintuple aim of improved population health, enhanced patient care, reduction of cost, better provider/care team experience, and advanced health equity for the funds/schemes under administration.

He/she is responsible for developing and implementing strategies for effective management of health risks in line with the Company's overall strategy and objectives, including oversight of the development of new health solution features for the key product areas that serve to drive revenue growth and profitability for the Company. He/she must work with cross-functional teams to develop and implement appropriate health risk management solutions and to ensure compliance with regulatory requirements and industry standards related to the delivery of managed health care.



He/she will work closely with a variety of stakeholders, coordinating the managed care activities across the enterprise to develop, implement, and evaluate HRM programs and initiatives. While the range of duties and responsibilities is broad and varied, the position's major responsibility is directing the day-to-day operations, financial management, and human resource management for the department.

Requirements

A tertiary clinical qualification is a prerequisite i.e. the incumbent must hold a Bachelor's degree in healthcare administration, public health, or related field. (e.g. BCur, BPharm or MBChB), although a Master's degree is preferred.
A business degree or equivalent will be considered an advantage
Minimum of 10 years of experience in healthcare, with at least 5 years in health risk management or related field.
Must have a sound working knowledge of medical scheme legislation and managed care compliance requirements and a proven track record in terms of the key competencies listed above, including strong leadership and problem-solving skills.

Duties & Responsibilities

Leverage broad knowledge and experience, principles, and technologies in providing guidance to product development and technical teams.
Assign product portfolios, projects or project elements to the team and clarify the goals and objectives for each capability.
Identify and resolve strategic issues that may impair the team's ability to meet strategic, financial, and technical goals.
Identify the human, technical and other resources necessary to adequately deliver the HRM solutions within budget.
Responsible for working closely with the strategic and tactical level and with peers cross-functionally to migrate creative product design concepts into finished, scalable, high quality commercialized goods that provide the Company with an advantage in the marketplace.
Engage with key stakeholders to identify changing client needs and make recommendations to align service offering with client needs.
Build and maintain relationships with clients and stakeholders that promote cross delivery practice solutions.
Foster a culture of continuous improvement and innovation within the various health risk management departments.
Make positive contributions to internal teams and stakeholder groups by contributing to a positive work climate and culture that gives meaning to work, minimises work disruption and maximises employee productivity.
Develop and implement cost-effective health risk management strategies to minimize the financial impact of high-risk members on the company.
Monitor and evaluate the financial performance of the health risk management department and make necessary adjustments to improve efficiency and effectiveness.

Competencies

Client/ Stakeholder Commitment
Drive for Results
Impact and Influence
Leads Change and Innovation
Diversity and Inclusiveness
* Motivating and Inspiring Team