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GOVERNMENT EMPLOYEES MEDICAL SCHEME (GEMS) 
 


COMPLAINTS MANAGEMENT SPECIALIST
Type: Permanent 
| Salary: The total remuneration package will be based on qualifications and experience.
Closing date: 23 May
 
The position of Complaints Management Specialist is vacant. The Complaints Management Specialist will report directly to the Senior Manager: Complaints Management and forms part of the Member Service and Experience Division. The position is based at Head Office in Pretoria.
The remuneration package for this position is negotiable based on qualifications and experience.
 
The Complaints Management Specialist will be required to provide support to the Senior Manager: Complaints Management through the implementation of the following Key Performance Areas (KPAs):
  • Provision of a quality complaints service for our customers by providing a clear and transparent process
  • Handling complaints effectively and supporting the Senior Manager: Complaints Management to find resolution for Members and/or healthcare providers who are dissatisfied with the service received from the Scheme
  • Ensure direct contact with members/healthcare providers who escalate their complaints directly to the Scheme taking initial complaint details, logging details, responding, preparing the draft statement of complaint and provide on ongoing communication updates
  • Provision of performance management information and learning outcomes to internal divisional heads and Business Service Units to support them in learning from complaints
  • Raising awareness of best practice in complaints handling across the Scheme through training programmes and a toolkit on the Intranet as well as other mediums
  • Carrying out complaints training within services and other partners where appropriate
  • Providing support to the Senior Manager during absence or heavy workload  
 
Qualification requirements are:
  • Minimum 3-year Degree or Diploma in Legal/Business Management
  • 5 – 8 years’ work experience of complaints handling or working in a customer service environment
  • Consulting Experience will be beneficial
  • Analytical Skills
  • Self-Management
  • Excellent written and verbal skills
  • Good reporting skills
  • Information gathering, research and analysis
  • Producing performance statistics
  • First class interpersonal skills, able to communicate with a wide range of people
  • Ethical focus on treating customers fairly
  • Courteous yet assertive
  • Trustworthy and reliable
  • Organised and methodical
  • High attention to detail
  • Respect for customer and business confidentiality
  • Have the ability to work well as part of a team
  • Be computer literate on advanced level
  • Self-motivated and pro-active
  • Have Strong negotiation skills and Deductive reasoning
  • Strong leadership qualities
  • have resilient pressure management abilities
  • Hands-on experience project studies and implementation
  • Must be in possession of a valid driver’s license and own vehicle and be willing to travel at short notice
  • Understanding of the Medical Scheme industry advantageous.  
 
 
All external candidates, please apply via Career Junction using the following link:https://www.careerjunction.co.za/companies/35144/government-employees-medical-scheme
 
The closing date for applications is 22 May 2023. Should you not hear from us by 31 July 2023, please consider your application unsuccessful. 
 
*** 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.
*** Kindly note that information is required for Employment Equity Purposes and information gathered is strictly used according to the intended purpose of collection, unless there is a legal need or permission is granted from the applicant themselves to make use of it for other purpose
*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.
*** GEMS adopts a hybrid work model
***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.



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ACTUARIAL SPECIALIST RD2302
Type: Permanent 
| Salary: The total remuneration package will be based on qualifications and experience. 
Closing date: 19 May
 
The position of Actuarial Specialist is vacant. The Actuarial Specialist will report directly to the Senior Manager Actuarial Services and forms part of Research and Development Division  of the Scheme based in Pretoria.
 
The total remuneration package will be market related and is negotiable, based on qualifications and experience.
 
The Actuarial Specialist  will be required to support the Senior Manager Actuarial Services through the following KPA’s:
 
Key Performance Areas (KPAs):
  • Provide accurate monthly and annual forecasts with appropriate well considered analysis and risk adjustments.
  • Identify and effectively communicate cost efficiency opportunities.
  • Analyse industry benchmarks and provide recommendations for the scheme’s performance.
  • Conduct relevant research to identify trends and improve scheme performance.
  • Analyse claim handling trends and identify areas of concerns.
  • Analyse provider profile benchmarks and identify trends.
  • Analyse data from 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.
  • Assist in designing and putting into operation actuarial processes.
  •  Evaluating, processing, analysing, and interpreting statistical data and preparing them for publication, scientific papers and reports.
  • Studying and improving actuarial and statistical theories and techniques for application in the organization
 
Qualification requirements are:
  • B.Sc. or equivalent degree in Actuarial Science
  • Newly or nearly qualified actuary
  • Min of 5 years of experience in actuarial role, with 3 years in managerial role
 
Behavioural Competencies
  • Good experience of Advanced Analytical Modelling tools e.g., SQL, SAS, R
  • Strong Report writing and presentation skills with high proficiency in MS Office, particularly Word, PowerPoint, Excel
  • Strong actuarial model development, data analysis and manipulation experience
  • Strong research, qualitative and quantitative analytical abilities
  • Good interpersonal skills
  • Strong risk management knowledge
  • Good written and oral communication skills especially at Board and Senior management level of the organization
  • Knowledge of finance, accounting, and economics – especially health related
  • Excellent problem-solving capabilities/Statistical analysis skills
  • Solid understanding of complex and technical concept
  • Ability to maintain confidential information and exercise discretion and tact
  • Presentation skills
  • High level of integrity and excellence
  • Excellent attention to details
  • Have the ability to work well as part of a team
  • Have a diligent work ethic with attention to detail
  • Interpersonal skills
 
Desirable
  • A background in healthcare is advantageous, but candidates from other actuarial areas are also free to apply
 
 
All external candidates, please apply via Career Junction using the following link:https://www.careerjunction.co.za/companies/35144/government-employees-medical-scheme
 
The closing date for applications is  18 May 2023. Should you not hear from us by 31 July 2023, please consider your application unsuccessful. 
 
*** 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.
*** Kindly note that information is required for Employment Equity Purposes and information gathered is strictly used according to the intended purpose of collection, unless there is a legal need or permission is granted from the applicant themselves to make use of it for other purpose
*** Should you wish to have your information removed from the GEMS database, kindly send a request in writing to jobs@gems.gov.za.
*** GEMS adopts a hybrid work model
***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.