Head of Customer Solutions – Cosmopolitan Health Insurance

Job Description

KEY RESPONSIBILITIES

• Provide strategic leadership and direction for the Customer Solutions Department.
• Develop and implement policies, SOPs, and strategies to enhance service delivery, client satisfaction, and retention.
• Oversee client relationship management, including SLA monitoring and service performance standards.
• Lead contract renewals, deactivations, invoicing accuracy, and payment follow-ups.
• Oversee effective handling and resolution of client and member complaints and grievances.
• Manage member care operations, including 24-hour call center services, pre-authorizations, and medicine delivery.
• Monitor customer satisfaction surveys and service data, and provide reports with recommendations to Management.
• Ensure timely delivery of client utilization reports and processing of refunds.
• Develop and manage the department’s annual operating budget.
• Prepare periodic performance and service delivery reports for Management decision-making.
• Supervise, mentor, and develop team members, including performance management and succession planning.
• Ensure efficient allocation of departmental resources and adherence to company policies.
• Perform any other duties as may be assigned by the CEO.

INTERNAL & EXTERNAL RELATIONSHIPS

Internal: Heads of Departments, employees across all units.
External: Policyholders, clients

JOB SPECIFICATION

Education, Professional Qualification & Experience

• Master’s Degree in Business Administration, Customer Service Management, Marketing or any related field.
• Preferably a member of a recognized professional body in Customer Service, Marketing or a related field.
• 7 years of relevant experience in customer service management or client relations management or any related field with at least, 3 years in managerial role, preferably within the health insurance industry.

Technical Competencies

• Proficiency in customer relationship management systems.
• Strong understanding of health insurance operations and client care protocols.
• In-depth knowledge and understanding of operational service delivery management as well as customer satisfaction improvements techniques. 
• Ability to establish, maintain and deepen partnerships with customers, and identify and drive profitability within the portfolio. 
• Proven success in strategic account management/sales and portfolio planning. 
• Good understanding of customer’s business and market sector to anticipate how future services offer to evolve customer requirements. 
• Excellent knowledge/understanding of customer service management principles. 
• Strong contract negotiation and client management skills. 
• Ability to build a value proposition through effective probing and understanding of the customer’s business model. 
• Ability to strategically orient with competitive awareness and benchmarking. 
• Good knowledge in the use of Microsoft Word, PowerPoint, Excel and internet and other service delivery software and tools. 

Managerial Competencies

• Ability to coordinate and monitor activities of team members.
• Ability to delegate responsibilities effectively.
• Ability to plan and execute programs to meet deadlines.
• Ability to take sound and timely decisions.
• Ability to solve problems.
• Ability to train team members.

Personality Competencies

• Ability to exhibit a high moral standard and level of integrity.
• Excellent communication and presentation skills.
• Strong analytical skills.
• Strong organizational and multi-tasking ability
• Ability to handle complex client issues with tact and professionalism.
• Ability to work in a fast paced and often pressured environment. 
• Ability to maintain confidentiality.
• Ability to relate well with people at all levels.
• Ability to pay attention to details.