Description

Job Description

Job title: Medical operations and system supervisor

Key responsibilities:

Production Monitoring and Reconciliation

• Oversee the end-to-end production cycle for the Medical Department to ensure completeness, accuracy, and operational continuity.
• Perform and supervise regular reconciliation between production records in the core policy administration system and CHI and claims/TPA systems to confirm alignment of quotation data , policy data, member counts, effective dates, this to be done for initial policy and endorsements
• Identify discrepancies between systems, investigate root causes, and coordinate timely resolution with the relevant internal teams, TPAs, IT teams, and vendors.
• Monitor CHI uploads and coordinate closely with the vendor managing CHI-related activities to ensure all issues are identified, followed up, and resolved in a timely manner.
• Track exceptions, mismatches, delayed transactions, and operational gaps, and maintain logs of reconciliation findings and corrective actions.
• Ensure that any production issues impacting downstream claims servicing, member data, provider eligibility, or reporting are escalated and resolved promptly.
• Work closely with policy operations and claims teams to ensure smooth production handoff and accurate implementation of policy changes.
• Support month-end and periodic production validation activities and ensure readiness of reconciled data for reporting, finance, and management review.

2. System Production Support

• Monitor system performance related to production setup, policy issuance, endorsement processing, eligibility updates, and related medical operational activities.
• Coordinate with IT and system vendors to resolve production issues, defects, data errors, workflow interruptions, and interface failures.
• Ensure proper tracking, prioritization, and closure of production support tickets and system incidents affecting medical operations.
• Assess the business impact of system-related issues and ensure critical matters are escalated on time.

3. Process Governance and Operational Control

• Ensure strong operational control across the medical production lifecycle by establishing and maintaining strong business rules , control points, and exception management mechanisms.
• Develop, maintain, and periodically update the standard operating procedures (SOPs) for Policy Operations and Underwriting to ensure they remain aligned with any changes implemented during the year
• Support internal governance over underwriting-to-operations-to-claims data flow to reduce leakage, errors, and service disruption.
• Support the Control function during audit reviews by preparing all required documents, data, and evidence for their regular review sessions, and coordinate on the audit observations report to ensure proper and timely responses are prepared.
• Highlight process weaknesses, manual dependencies, and control gaps, and recommend improvements.
• Support management in strengthening the operational framework around data quality, production integrity, and system discipline.

4. Digitalization and Transformation Initiatives

• Lead departmental initiatives, especially across Underwriting and Policy Operations, from requirement gathering through implementation, including drafting business requirements and BRDs, coordinating with IT and relevant stakeholders, following up on progress, and performing user testing to validate that the final output meets business needs.
• Identify opportunities to automate manual activities, improve system workflows, reduce turnaround time, and enhance operational control.
• Translate business process requirements into practical system and digital enhancement initiatives.
• Work with internal stakeholders, IT teams, and vendors to implement new digital capabilities that improve operational effectiveness and user experience.
• Support the design and rollout of workflow automation, digital document handling, submission management, communication tracking, and reporting solutions.
• Participate in transformation projects involving medical underwriting workflow, policy onboarding, endorsement management, claims integration, and customer/service experience enhancements.
• Ensure new initiatives are aligned with business objectives, operational priorities, compliance requirements, and departmental strategy.
• Monitor implementation progress of transformation projects and follow through on action plans, milestones, testing, and adoption.
• Contribute to continuous improvement of the medical operating model by promoting digitization, standardization, and enhanced control.

5. Reporting and Management Information

• Develop and maintain operational reports and dashboards related to production, reconciliation, system support, pending issues, and transformation initiatives.
• Generate regular reports showing production movement, system discrepancies, unresolved mismatches, turnaround times, and operational performance indicators.
• Support management with analysis and visibility on production health, operational bottlenecks, reconciliation status, and process efficiency.
• Track trends, recurring issues, and performance gaps and provide actionable insights to management.
• Ensure required business data fields are captured in systems to support meaningful reporting by product, segment, region, channel, underwriter, or other dimensions as needed.
• Contribute to management presentations and business reviews by providing accurate production and system-related operational data.

6. Stakeholder and Vendor Management

• Coordinate with internal stakeholders across underwriting, policy operations, claims, finance, IT, compliance, and management to ensure smooth production support and transformation delivery.
• Liaise with external vendors, TPAs, and technology providers on system issues, reconciliations, enhancements, integration matters, and operational performance.
• Follow up with vendors on incidents, deliverables, agreed action plans, and service quality issues.
• Ensure business requirements are clearly communicated to IT/vendors and that solutions delivered are aligned with operational needs.
• Participate in vendor discussions related to system improvements, interface changes, reporting enhancements, and operational workflow redesign.
• Evaluate vendor responsiveness, support quality, and effectiveness in resolving medical system and production-related requirements.

7. Testing, Implementation, and Change Support

• Support user acceptance testing for system enhancements, bug fixes, integration updates, and transformation projects affecting the Medical Department.
• Validate that implemented changes meet business requirements and do not negatively impact production flow or operational stability.
• Prepare test scenarios and business cases relevant to medical production, underwriting, policy operations, and claims processes.
• Work closely with users to obtain feedback during testing and post-implementation stages.
• Ensure proper implementation follow-up after go-live and confirm that issues are addressed in a timely manner.
• Support change management activities, including communication, process updates, user guidance, and training coordination.

Education:

• Bachelor Degree in business administration , computer science or similar major

Experience:

• 10 Years

Personal Attributes / Skills:

• Excellent quantitative, analytical, and problem-solving skills.
• Strong understanding of insurance systems, products, and operational workflows
• Superior to excellent communication, interpersonal and organizational skills
• High degree of self-motivation and creative problem solving

Requirements added by the job poster

• No need for visa sponsorship

• 5+ years of Insurance experience