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Careers at

GEMS

 

 

Job Advert: Client Liaison

Operations Manager 

Gems

The position of Client Liaison Operations Manager is vacant. The Client Liaison Operations Manager will report directly to the Senior Manager Client Liaison and forms part of the Member Service and Experience Division. The position is based at Head Office in Pretoria.

The total remuneration package for this position negotiable based on qualifications and experience.

The Client Liaison Operations Manager will be required to  assist and support the  Senior Manager  Client Liaison through the implementation of the following

Key Performance Areas (KPAs):

  • Develop and monitor standards drafted to ensure compliance to established specifications and requirements.
  • To ensure quality assurance, completeness and accuracy of submissions of reports and memo documents by setting and implementing standards as well as reviewing presentations.
  • Verify completeness of information on submissions
  • Coordinate support and training in Regions on quality assurance
  • Develop, implement and manage monitoring system
  • Advise and assist the Unit with on all issues of compliance regarding policy and standard operating systems.
  • Review and update standard operating procedures or quality assurance manuals.
  • Interpret and compare standards to established specifications and control limits, and make recommendations on appropriateness for release.
  • Identify quality problems or areas for improvement and recommend solutions.
  • Investigate or report questionable standards.
  • Participate in out-of-specification investigations and recommend corrective actions.
  • Perform validations and reviews of standards in accordance with applicable policies or guidelines.
  • Communicate quality control information to all relevant reports, documents and memos
  • Provide feedback and interpretation to relevant stakeholders, members and customers.
  • Instruct staff in quality control and analytical procedures.
  • Work with Regions on quality guidelines, testing procedures, or ways to eliminate deficiencies.
  • Monitor performance of quality control systems to ensure effectiveness and efficiency
  • Supply quality control information necessary for regulatory submissions.
  • Compile and submit technical reports or documentation.
  • Stakeholder Relations
  • Oversight and management of risk and audit Initiatives
  • Assist with Divisional Reporting

Qualification requirements are:

 

  • At least Degree or National Diploma  or Quality Management qualification  
  • At least 5 years’ work experience in a similar role with 3 years of management experience
  • Good planning and organising skills
  • Communication Statistical analysis
  • Excellent technical skills
  • Time management
  • Have strong problem solving andnegotiation skills
  • Be organised and have good time & project management skills
  • Be analytical and have the ability to manage priorities
  • Have excellentwriting skills, verbal communication and interpersonal skills and good presentation skills
  • Have the ability to work well as part of the team
  • Be computer literate on advanced level
  • Must have advanced Ms Excel Skills and PowerPoint Skills
  • Interpersonal skills
  • Have a diligent work ethic with attention to detail
  • Drivers Licence
  • Self-motivated and pro-active
  • Have resilient pressure management abilities
  • Innovation (new initiatives)

Should you be interested, please apply for the position by emailing your CV to jobs@gems.gov.za The closing date for applications is 22 October 2021. Should you not hear from us by 31 December 2021, please consider your application unsuccessful.

Note that only internal candidates should apply using the email address noted above. All external candidates should apply via Career Junction.

***GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.

*** Information is used for Employment Equity Purpose.

*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.

*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing tojobs@gems.gov.za.

***Gems is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with Gems employment equity plan.

 

 

Advert – Actuarial Analyst

 

WSRD05

Gems

The position of Actuarial Analyst is vacant. The Actuarial Analyst will report directly to the Senior Manager: Actuarial Services and forms part of the Research and Development Division. The position is based at GEMS Head Office, Pretoria.

The total remuneration package will be will be based on qualifications and experience.The Actuarial Analyst will monitor the financial performance of the Scheme, provide budgetary guidance, analysis of claims, actuarial analysis reports, update actuarial models and develop new models through the following KPA’s:

 

Key Performance Areas (KPAs):

  • Monthly and annual forecasts with appropriate analysis and risk adjustments
  • Analysis industry benchmarks and provide recommendations for improvement
  • Analysis claim handling trends
  • Integrate data to determine trends from fraud waste and abuse
  • Evaluate, process, analyse and interpret statistical data for reporting
  • Plan and organise surveys and other statistical data collection

     

Qualification requirements are:

  • B.Sc. or equivalent degree in Actuarial Science.
  • Minimum of 0-2 years’ experience in a similar role a
  • Good progress with A100, A200) exams, with the number of exemptions obtained at university an added advantage
  • Problem-solving and analytical skills
  • Accurate and strong attention to detail
  • Good written and oral communication skills
  • Report writing and presentation skills
  • Self-starter
  • Team player with ability to work independently
  • Programming skills e.g. knowledge in SAS, R, SQL and a strong interest in programming
  • Computer literate with some experience with MS Office, particularly Word, PowerPoint, Excel

Desirable

  • Have an understanding of medical schemes industry

Should you be interested, please apply for the position by emailing your CV to jobs@gems.gov.za

*** GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.

*** Information is used for Employment Equity Purpose.

*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.

*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.

***Gems is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with Gems employment equity plan.

 

 

 

Advert – Senior Manager: Actuarial Services

 

WSRD01

 Gems

 
 
 
 
 
 
 
 

 

The position of Senior Manager Actuarial Services is vacant. The Senior Manager Actuarial Services will report directly to the Chief Research Officer and forms part of the Research and Development Division. The position is based at GEMS Head Office, Pretoria.

The total remuneration package will be will be based on qualifications and experience.

The Senior Manager Actuarial Services will provide actuarial services to GEMS through the following activities: Establish and oversee the activities of the actuarial staff including selection, mentorship and coaching, workload and performance management, Develop mathematical analyses and apply actuarial principles to solve problems for the organisation, Advise the CRO, Principal Officer and Scheme management based on thorough research, insight and predictive analysis through the following KPA’s:

Key Performance Areas (KPAs):

  • Establish and oversee the Actuarial capabilities in the organisation
  • Provide accurate monthly and annual forecasts with appropriate well considered analysis and risk adjustments.
  • Identify and communicate cost efficiency opportunities
  • Provide industry benchmarks and recommendations.
  • Identify claim trends and provide solutions
  • Analyst provider profile benchmarks and identify opportunities to improve benefit offerings
  • Analyse various information sources to determine trends that emanate from fraud, waste and abuse.
  • Analyse GEMS processes and information, identify key areas of efficiency, effectively communicate intervention recommendations.
  • Conducting logical analysis of management problems, especially in terms of input-output effectiveness, and formulating mathematical models to problems.
  • Designing and putting into operation systems to enable actuarial analysis.
  • Advising on and applying various data collection methods and statistical methods and techniques, and determining reliability of findings.
  • Planning and organizing surveys and other statistical data collection, and designing questionnaires.
  • Studying, improving and developing actuarial and statistical theories and techniques for application in the organization.

Qualification requirements are:

  • B.Sc. or equivalent degree in Actuarial Science.
  • Fellow of the Actuarial Society of South Africa (“FASSA”) and holding a Practicing Certificate in Healthcare issued by ASSA.
  • Minimum 8+years actuarial experience.
  • Minimum 3+ years healthcare experience, including pricing, benefit design, IBNR calculations, experience monitoring of medical schemes.
  • Strong risk management experience.
  • Strong stakeholder management experience.
  • Statistical analysis skills.
  • Experience of Advanced Analytical Modelling tools e.g. SAS, R
  • Actuarial model development, data analysis and manipulation experience
  • Knowledge of finance, accounting and economics – especially health related
  • Report writing and presentation skills and being proficient in MS Office, particularly Word, PowerPoint, Excel.

Should you be interested, please apply for the position by emailing your CV to jobs@gems.gov.za

*** GEMS employs people with the highest level of integrity – submission to the appropriate pre-employment assessment is obligatory to be considered for the position.

*** Kindly note that the information provided on application of the position may be shared with a third party for vetting purposes and will be stored by GEMS for a period of 5 years.

*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za

***Gems is guided by the principles of employment equity. Preference will be given to groups who are underrepresented in accordance with Gems employment equity plan.

 

 

Life at GEMS

Life at GEMS 

At GEMS we value our employees and we continuously work towards creating a positive employee experience at all levels. Our values and ethics drive a business culture that encompasses a positive work ethos and environment for our employees to thrive and grow in. We offer our employees exceptional opportunities to develop and grow by participating in our robust learning and development programmes.

Our focused leadership team continuously strives to maintain a culture that fosters a healthy and positive work environment that respects the dignity and diversity of each member of our organisation while providing support in a workplace that is built on the cornerstones of ethics and collaboration.  

We encourage our young workforce to deliver excellence in the work they do while driving innovation to create a valuable experience for our members. 

GEMS continues to focus on transformation within the healthcare industry and emphasises the need to employ people living with a disability. We have an employment equity plan and a disability strategy that is monitored closely to reach our transformation targets.

GEMS has low levels of employee attrition and have strategies in place to retain our key talent. We have a formal Performance Management and Rewards Programme that aligns with our scheme values and we recognize great performance. We also offer rewards and recognition awards to our top performing employees.

GEMS recruitment process 

The GEMS recruitment process is focused on attracting skilled talent that align with our scheme’s values and ethics to ensure that we recruit individuals who fit our results driven culture.

We use various platforms to source candidates and we have a strong focus on employment equity and transformation when we appoint candidates.

At GEMS we pride ourselves on being meticulous in our recruitment and placement process. We ensure that our new hires receive only the best from us during the recruitment and onboarding processes to ensure a seamless integration into the organisation.