Job Vacancies (2 Positions)

JOB SUMMARY

To ensure prompt processing of medical claims.

PRINCIPAL ACCOUNTABILITIES.

• Manage Claims Ratio as per target
• Use claims tariff during claims payment and signing with providers
• Prompt claims settlement as per agreement with providers
• Reconcile service provider account and close issues arising
• Enhance claims documentation for better adjudication
• Pharmacy claims management
• Smart claims monitoring
• Major provider management
• Contain Optical claims
• Reduce drug cost through implementation of Pharmacy Book
• Claims vetting and adjudication
• Effective communication
• Provider and customer Email management
• Complaints resolution time
• Management of reimbursement Claims
• Compliance to Procedure Manuals
• Ensure complete and efficient implementation of e-Oxygen and its integration with other systems.
• Departmental meeting
• Process reviews yearly
• Individual Performance management
• Report your duties monthly on time (on 5th of the month)
• Any other task as assigned by your Line Manager

Qualifications and experience

• University degree in health-related field
• Basic Insurance qualification

Skills and competencies

• Good communication and negotiating skills
• Good attention to details and accuracy
• Good analytical and monitoring skills
• User IT skills in database management and office systems.
• Good interpersonal skills
• Thorough understanding of policy covers/wordings and their interpretation as pertaining to claims

Integrity and honesty

Please visit our careers page through: 

https://oldmutual.wd3.myworkdayjobs.com/en-US/Old_Mutual_Careers/details/Claims-Analyst_JR-58805?q=rwanda

Interested candidates are requested to submit their applications by 5.00 p.m. 1st October 2024.

Applicants must possess or be in the process of applying for a POLICE CLEARANCE CERTIFICATE as at the time of making an application.

ONLY short-listed candidates will be contacted.

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JOB SUMMARY

The job purpose of a Business Analyst is to identify business needs, propose solutions, support core systems, and facilitate communication between stakeholders and system vendors to improve processes and achieve organizational goals.

PRINCIPAL ACCOUNTABILITIES.

• Analyze existing systems and redefining them to consider changes in system requirements or equipment configurations (Systems Automation)
• Collection and Analysis of project requirements, and Assistance to the developmental/Vendor team in optimizing their work.
• Providing developmental suggestions to the company and improving operational efficiency.
• To maintain and monitor system integrations (AIMS,EO2,D365 AND D365)
• Developing and directing software system validation and testing methods.
• Write and test code to ensure compatibility and stability: refine and rewrite, as necessary.
• Design, develop, modify, and implement software functionalities in the software full stack.
• Determine root cause for software issues and develop practical, efficient, and permanent technical solutions.
• Lead and develop procedures documentation for knowledge transfer.
• Working closely with system users and cross-functional departments to communicate project statuses and proposals.
• Analyzing data to effectively coordinate the installation of new systems or the modification of existing systems.
• Managing the software development lifecycle.
• Monitoring system performance and server performance.
• Communicating key project data to team members and building cohesion among teams.
• Creating innovative solutions to meet our company’s technical needs.
• Provide and assist in training and support to users for newly developed applications.
• To provide support, including procedural documentation and relevant reports
• Monthly reporting on system functionalities and critical exposures.
• To perform any other task that may be assigned by his superior.

Qualifications and experience

• BSc/Ba in Information Technology, Computer Science or a related discipline
• Professional certification (e.g. Agile, SQL, Power BI, Power Apps) would be an added advantage.

Skills and competencies

Analytical Skills

• Critical Thinking:Ability to analyze complex problems and develop innovative solutions.
• Data Analysis:Proficiency in interpreting and analyzing data to support decision-making.

Communication Skills

• Verbal Communication:Effective communication with stakeholders at all levels.
• Written Communication:Clear and concise documentation of requirements, reports, and other materials.

Technical Skills

• Software Proficiency:Familiarity with business analysis tools (e.g., MS Excel, SQL, BI tools like Tableau, Power BI).
• System Knowledge:Understanding of core systems, ERPs, CRMs, and their functionalities.
• Database Management:Ability to work with databases, write queries, and understand database design.
• Programming Basics:Basic knowledge of programming languages (e.g., Python, R) for data analysis.
• Requirements Management Tools:Proficiency in using tools like JIRA, Confluence, and Trello.
• Process Modeling:Skilled in using modeling tools like Visio, Lucidchart for creating process flows and diagrams.
• API Integration:Understanding of API functionalities and how to integrate different systems.
• System Testing:Ability to develop and execute test plans and test cases.
• Cybersecurity Awareness:Basic understanding of security principles to ensure data protection and compliance.

Project Management

• Organization:Ability to manage multiple tasks and projects simultaneously.
• Time Management:Efficiently plan and prioritize tasks to meet deadlines.

Problem-Solving

• Root Cause Analysis:Identify the underlying causes of issues and develop effective solutions.
• Decision Making:Make informed decisions based on data and stakeholder input.

Interpersonal Skills

• Stakeholder Engagement:Build strong relationships with stakeholders to understand their needs and expectations.
• Collaboration:Work effectively with cross-functional teams and vendors.

Business Acumen

• Industry Knowledge:Understand the industry landscape and business trends.
• Financial Literacy:Basic understanding of financial principles and business metrics.

Adaptability

• Flexibility:Adapt to changing business environments and requirements.
• Continuous Learning:Stay updated with new technologies and methodologies.

Attention to Detail

• Accuracy:Ensure precision in data analysis and documentation.
• Thoroughness:Conduct comprehensive reviews and validations of solutions.

Negotiation Skills

• Conflict Resolution:Resolve conflicts between stakeholders and vendors effectively.
• Persuasion:Influence stakeholders to gain consensus on proposed solutions.

Please visit our careers page through: 

https://oldmutual.wd3.myworkdayjobs.com/en-US/Old_Mutual_Careers/details/IT-Business-Analyst_JR-58804?q=rwanda

Interested candidates are requested to submit their applications by 5.00 p.m. 1st 0ctober 2024.

Applicants must possess or be in the process of applying for a POLICE CLEARANCE CERTIFICATE as at the time of making an application.

ONLY short-listed candidates will be contacted.