Service Manager Hospital Benefit Management

Job Advert Summary

We are recruiting for a Service Manager who will lead Managed Healthcare service delivery by ensuring achievement of service level agreements, quality standards, and operational efficiency, while maintaining compliance with scheme rules, clinical and funding protocols, SOPs, and legislation. The incumbment will be accountable for people leadership, performance management, and capability development, and drives continuous improvement, risk management, and cross-functional collaboration to deliver a consistent, member-centric service and support sustainable scheme performance.

Minimum Requirements

Education

• Grade 12
• A relevant clinical qualification with current professional registration (where applicable) is essential
• A qualification in healthcare management, business management, or a related field is advantageous
• Management, leadership, or coaching training is advantageous.

Experience

• Minimum of 4 years’ experience in a managed healthcare, medical scheme administration, or healthcare operations environment
• Minimum of 4 years’ experience in a supervisory or people management role
• Experience in service delivery management, including turnaround times, quality standards, and productivity management
• Experience in applying scheme rules, clinical and funding protocols, policies, work instructions, and service level agreements
• Experience in performance monitoring, reporting, and trend analysis to drive operational improvement
• Experience in managing escalations, stakeholder engagement, and cross-functional problem solving
• Experience in risk identification, mitigation, and audit processes within a regulated healthcare environment
• Exposure to disease risk management, pre-authorisation, case management, or related managed healthcare functions is advantageous

Duties and Responsibilities

1. Service Delivery & Operational Management

• Lead and manage day-to-day service delivery to achieve service levels, turnaround times, quality standards, and productivity targets
• Monitor operational performance, analyse trends, and identify service gaps
• Implement corrective actions to improve outcomes, efficiency, and consistency
• Support implementation of business and operational changes aligned to service delivery standards

2. Compliance, Governance & Risk Management

• Ensure adherence to scheme rules, clinical and funding protocols, internal policies, SOPs, and legislation
• Identify, assess, and manage operational and clinical risks
• Ensure mitigation actions are implemented, tracked, and escalated appropriately
• Maintain alignment to contractual obligations and governance requirements

3. Quality Assurance & Continuous Improvement

• Drive quality assurance and audit readiness across processes and controls
• Ensure SOPs, documentation, and controls are consistently applied and maintained
• Identify and implement process improvements and operational initiatives
• Strengthen controls and optimise service delivery for consistency and efficiency

4. People Leadership & Capability Development

• Lead, coach, and develop team members
• Drive performance management, workforce planning, and training support
• Build team capability to meet operational and service delivery demands

5. Stakeholder Management & Escalation Handling

• Manage escalations, resolving complex queries, service failures, and stakeholder concerns
• Collaborate with internal stakeholders, healthcare providers, and scheme/client representatives
• Support issue resolution and enhance overall service delivery

6. Reporting & Insights

• Compile and review operational performance reports
• Provide insights and recommendations to support management decision-making