Health Executive – Operations

Job Description About the Role We are seeking an experienced and strategic Health Executive: Operations to lead and optimise all operational functions within our health insurance business. This is a critical executive leadership role responsible for ensuring the efficient, compliant, and customer-centric delivery of services across the full operational value chain. The successful candidate will play a key role in driving operational excellence, enhancing member and stakeholder experience, and enabling sustainable business growth through strong leadership, governance, and continuous improvement. Key Responsibilities Operational Leadership & Strategy Develop and execute operational strategy aligned with overall business objectives Translate strategic priorities into actionable plans across all operational divisions Foster a high-performance, service-oriented culture Ensure alignment across operations, product, distribution, and clinical teams Oversight of Core Operational Functions Lead and ensure performance across: Claims Management

• adjudication, clinical validation, fraud prevention, and cost control Underwriting & Policy Administration
• risk assessment, onboarding, and policy lifecycle management Customer Service & Call Centre Operations
• multi-channel member and broker support Provider Network & Hospital Relations
• contracting, partnerships, and service quality oversight Membership Onboarding & Servicing
• seamless onboarding and ongoing member administration Billing Administration
• premium billing, collections, reconciliations, arrears management, and financial accuracy in partnership with Finance Virtual Care & Digital Health Services
• telemedicine, digital platforms, and remote care innovation Scheme / Product Administration
• administration of benefits and scheme rules in line with regulatory requirement Customer & Stakeholder Experience Champion a customer-centric operating model Improve turnaround times, service quality, and first-contact resolution Build strong relationships with members, providers, brokers, and regulators Monitor and enhance satisfaction and retention metrics Financial & Performance Management Manage operational budgets and drive cost efficiency initiatives Improve cost-to-serve and operational productivity Establish and monitor KPIs, dashboards, and reporting frameworks Identify opportunities for operational scalability and efficiency Governance, Risk & Compliance Ensure adherence to all regulatory and compliance requirements Oversee operational risk management, including fraud mitigation Maintain strong internal controls and audit readiness Partner with Risk and Compliance functions to uphold best practices Process Optimisation & Digital Enablement Lead continuous improvement initiatives (Lean, Six Sigma, automation) Drive digital transformation across operational processes Enhance system integration, data usage, and decision-making capabilities Improve operational resilience and scalability People Leadership