Medical Aid Operation Manager jobs

A Medical Aid Administrator is seeking a Team Leader to provide clarity, consistency, accountability and to preserve strong governance and ethical decision-making. This role will support both Consultants and Service Managers, in order to ensure that Managed Care remains sustainable, compliant, and high performing.

Duties:

1. People Leadership

• Act as the primary Line Manager for assigned Consultants
• Manage attendance, scheduling, leave planning, and shift adherence
• Conduct regular one-on-one check-ins and performance conversations
• Address first-line performance, conduct, and behavioural issues
• Support onboarding and integration of new team members

2. Operational Delivery

• Manage daily queues, workflow, and task allocation
• Ensure adherence to agreed service levels (TATs, SLAs)
• Balance workload across consultants to maintain service continuity
• Act as the first point of escalation for operational issues

3. Quality & Standards Enforcement

• Ensure consultants apply scheme rules, SOPs, and clinical protocols correctly
• Address quality issues identified through QA feedback
• Reinforce consistent documentation and defensible decision-making
• Support corrective action plans arising from audits

4. Coaching & Support (Non-QA)

• Provide in-the-moment guidance to Consultants struggling with cases
• Reinforce learning from training and QA feedback
• Escalate systemic training needs to Service Managers and QA

5. Performance Monitoring & Reporting (Team-Level)

• Monitor daily and weekly team performance using standard operational dashboards and reportsprovided centrally
• Track volumes, productivity, attendance, and SLA adherence at team level
• Identify early warning signs of backlog, capacity pressure, or performance drift
• Provide qualitative insight and context to the Service Manager on emerging trends
• Support implementation of corrective actions agreed at Service Manager level

Requirements:

• Matric/Grade 12
• SANC Registered Nurse
• Strong working knowledge of Managed healthcare rules and processes
• Demonstrated leadership credibility among peers
• Ability to balance performance discipline with supportive leadership
• High ethical standards and respect for governance frameworks
• Customer Service experience
• Business Writing
• MS Office
• Good knowledge of ICD 10 codes, medical conditions and terminology
• Knowledge of Microsoft Office applications (Word, Excel, PowerPoint, Internet)
• Good interpersonal skills and capability to interact with people at all levels

Pay: R42 000,00 - R44 000,00 per month

Application Question(s):

• Are you a South African born, SANC Registered Nurse?
• Do you have experience working in a Medical Aid Scheme environment, as a Team Lead or 2nd-in-charge or Supervisor?
• Are you willing to accept a salary of R44 000 per month? (This is a non-negotiable)

Work Location: In person