Fresh Jobs at Reliance HMO

Description

• This role is responsible for the design and execution of case management processes at Reliance Health that improve enrollee safety and reduces amount spent on claims secondary to waste, abuse and fraud.   

Responsibilities

• Data-driven analysis of enrolee feedback to understand trends.  
• Develop and execute a structured process to investigate cases associated with mortality, morbidity, fraud, waste, and abuse.   
• Develop and execute structured standards for inclusion or exclusion of medical providers on Reliance Health’s network.  
• Develop and execute policies and procedures to support enrolees and quantifiably improve outcomes for those requiring emergency or prolonged care and those experiencing critical illness.   
• Develop policies and practices to improve safety for enrolees seeking care within our provider network.  
• Develop policies and practices to improve medical quality within our provider network.  
• Own key performance indicators around provider quality feedback from stakeholders and reduction of claims paid for low-value, dangerous or negligent care.   

Requirements

• Minimum of Bachelor of Medicine and Bachelor of Surgery (MBBS) 
• Minimum 2 years medical experience caring for patients.   
• Minimum 1 year of proven experience leading and managing of team.  
• Additional training or experience in medical quality improvement and/or population health, data analysis skillsets is required.   
• Excellent analytical, problem solving, communication, data analysis and numeracy skills are a must have for this role.   
• Highly organized, detail-oriented, self-directed, and goal-driven with strong leadership and managerial skills   
• Successful record of accomplishment in a fast-paced organization   
• Ability to execute, accelerate impact and lead change.   
• A customer success, claims, case management, provider/insurance related work history is an added advantage.   
• Advanced proficiency in the use of Microsoft Office tools including Word, Outlook and Excel.   
• Ability to use data to drive decision making and problem solving.  
• Ability to develop and carry out protocol to support users in emergency and critical medical illness.   
• Strong crisis management and relationship management skills.  
• Must be physically present in Lagos.  
• Willingness to travel when required.  

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Description

• The Operations Manager will oversee the day-to-day operational activities across multiple departments to ensure smooth, efficient, and cost-effective operations. This role requires strong leadership, analytical skills, and operational expertise to optimize processes, manage resources, and drive continuous improvement.

Operational Efficiency:

• Develop and implement standard operating procedures (SOPs) to improve efficiency across departments.
• Regularly review workflows and identify opportunities to streamline processes and reduce redundancies.
• Monitor and ensure adherence to operational timelines and service-level agreements (SLAs).

Resources and Budget Management:

• Prepare and manage departmental budgets, ensuring cost controls and alignment with financial targets.
• Optimize resource allocation, including staffing, tools, and technology, to achieve operational goals.
• Provide monthly reports on budget performance, variances, and corrective actions.

Vendor and Contract Management:

• Oversee vendor selection, contract negotiations, and performance evaluations.
• Ensure timely renewal of vendor contracts and adherence to service terms.
• Address vendor-related issues to minimize operational disruptions.

Team Leadership and Development:

• Lead, train, and mentor the operations team, fostering a culture of accountability and continuous improvement.
• Conduct regular performance reviews and provide actionable feedback for team development.
• Develop succession plans to ensure operational continuity.

Operational Data and Reporting:

• Establish KPIs and regularly track operational performance metrics.
• Create and deliver performance dashboards for leadership review.
• Use data analytics to identify trends and propose improvements.

Cross-Functional Collaboration:

• Work closely with teams such as IT and People Partners to address cross-departmental operational dependencies.
• Support onboarding processes by ensuring operational readiness for new hires.
• Collaborate with stakeholders on strategic projects and initiatives.

Risk Management and Compliance:

• Identify operational risks and develop mitigation strategies.
• Ensure all operations comply with company policies, safety standards, and local regulations.
• Regularly review compliance reports and address any gaps.

Continuous Improvement Initiatives:

• Proactively identify opportunities for innovation and improvement in operational processes.
• Implement projects aimed at enhancing productivity and reducing operational costs.
• Foster a problem-solving mindset across the team.

Requirements

• Bachelor’s degree in business administration, Operations Management, or a related field.
• 5+ years of experience in operations management, preferably in high-growth or dynamic environments.
• Proven track record of managing operational processes, budgets, and cross-functional teams.
• Strong analytical and problem-solving skills, with experience in data-driven decision-making.
• Excellent leadership and team management capabilities.
• Proficiency in operational tools and software systems for monitoring and reporting.
• Strong communication and interpersonal skills, with the ability to work collaboratively across departments.
• Experience in vendor and contract management.

Benefits

• Join a market leader within the Health Insurance space
• Remote-first work environment
• Work alongside & learn from best-in-class talent
• Attractive compensation & benefits
• Great work culture
• Work and learn from some of the best in the industry