Business Manager – Medical Aid Administration

Business Manager – Medical Aid Administration

About the role As the Business Manager, you will oversee the non-clinical, operational, and commercial strategies of our medical aid schemes. Your primary goal is to ensure exceptional client retention, high-speed claims processing accuracy, strict compliance with the regulations, and optimal financial management of monthly operating budgets/ performance.

Key Responsibilities

• Operational Leadership: Direct the end-to-end processing of medical insurance schemes onboarding, claims process sensitizations, managing daily workflows to eliminate backlogs and exceed Service Level Agreements (SLAs).
• Client Portfolio Management: Serve as the strategic point of contact for corporate HR partners and scheme trustees, managing account renewals, utilization reporting, and executive presentations.
• Network & Tariff Negotiations: Establish and manage commercial partnerships with private hospitals, clinics, and pharmaceutical networks to secure competitive tariff structures.
• Financial & Risk Management: Monitor monthly member contribution collections, optimize administrative operational budgets, and implement data-driven fraud detection measures.
• Compliance Oversight: Maintain absolute alignment with national healthcare policies, statutory guidelines, and stringent data protection rules regarding patient medical records.
• Team Development: Mentor, train, and evaluate a high-performing team of administrative staff, claims processors, and client relationship officers.

Requirements & Qualifications

• Education: Bachelor’s degree in nursing preferred or Healthcare administration postgraduate qualification is a distinct advantage.
• Experience: Minimum of 5+ years of operational experience within health insurance, medical aid administration, or Third-Party Administration (TPA), with at least 2 years in a direct managerial or supervisory role mandatory
• Technical Savvy: High proficiency in specialized health insurance administration software, advanced CRM database tools, rules and medical billing structures.
• Core Skills: Outstanding contract negotiation skills, robust financial acumen, strategic problem-solving abilities, and executive communication presence
• Driver’s License – Mandatory, valid and clean

What We Offer

• A highly competitive salary package reflective of experience. No constraints for the right candidate
• Clear career progression pathways within an expanding corporate group