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Education
Skills
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Strelitzia Monde More

Strelitzia Monde More

Soweto

Overview

39
39
years of professional experience
15
15
years of post-secondary education

Work History

Hospital Benefit Management

Universal Healthcare
02.2023 - Current
  • Managing a Team of Pre-Authorisations, 20 agents including 2 Team Leaders
  • Health Risk Assessment
  • Revision and ensure compliance to Clinical protocols & SOP's
  • Assist with Clinical decisions
  • Assisting with ensuring that the scheme rules are correctly interpreted and set up on system (e.g Copayments)
  • Mentor, coach, motivate and retain staff
  • Coordinate staff recruitment and liaise with HR department
  • Motivation for change: Career development

Operations Manager- Contact Centre

RX Health
08.2021 - 05.2023
  • Managing a Team of Pre-Authorisation, Care Team and Client Servicers - 30
  • Established and manage an integrated client services and clinical pre-authorisation Contact Centres
  • Managing the Care team
  • Setting of company objectives and individual staff goals
  • Analysis and interpretation of various Contact Centre metrics to render a world class service
  • Mentor, coach, motivate and retain staff
  • Coordinate staff recruitment and liaise with HR department
  • Participate in developing performance plans, set goals and objectives
  • Plan and co-ordinate duty roster, shift allocations and the number of staff required to meet demand
  • Personally attend to the most complex customer complaints or enquiries
  • Prepare reports on these statistics, rates and performance levels
  • Presentation of reports to senior management as well as other key stakeholders, such as clients of the medical schemes serviced
  • Review the performance of staff, identify training needs and plan knowledge transfer and training sessions in collaboration with the HR department
  • Recruitment of new staff
  • Motivation for change: Career development
  • Achievement: Successfully integrated the Client Services Call Centre and Managed Care Pre-Auth Call Centre
  • Formulated SMART Key Performance Areas (KPA's)
  • Improved Client Services performance
  • Entrenched the Housekeeper to assist with the Client Services Admin tasks

Bonitas Client Operations Manager- Administration Support/ Back Office

Medscheme Holdings Pty (Ltd)
07.2012 - 07.2021
  • Managed a team of 73 - 5 Teams Leaders- Clinical Assessors, Special Case Managers
  • Managed daily operations (service levels, staffing requirements, quality of work, voice of the customer and other key metrics for productivity) of the organization and ensured IT reliability
  • Work with Senior Executives on developing as well as implementing short- and long-term business objectives and opportunities
  • Ensure that the company Balance Score Card is achieved
  • Operationalization of the Company and the Client Strategies
  • Risk Management & Cost containment
  • Ensure that the ISO processes and standards are adhered to
  • Development of the Team leaders
  • Performance management of staff, to ensure that the KPI's are achieved
  • Ensure that the department is operating within set Budget
  • Ensure staff development by Multitasking and Organization of training
  • Attend to escalated queries and complaints (telephone /correspondence)
  • Formulation and analysis of reports to be presented to the Senior Managers, General Manager, CEO and BOT
  • (Chief Operations Officer, Chief Executive officer and Board of Trustees)
  • Authorisation of Ex-gratia payments and Exclusions overrides (evaluate and approve as per clinical indication)
  • Adjudication of Stale claims as per The Fund Mandate, ensured that correct billing principles is adhered to
  • Projects Management, such as Year- end loading of rules and UAT thereof, take-on and process improvement projects
  • Stakeholder Management
  • Ensure that Service Level Agreement is achieved and maintained to ensure that no penalties are paid (90 % of queries received to be resolved within 1 business day; Claims queries to be actioned within 5 days, maintain the VOC (Voice of the customer) score of 85% satisfaction, 95% Escalation queries to be resolved within 1 business day)
  • Recruitment & Induction of new staff
  • Ensure that Good Client relationship is maintained
  • Maintaining good relationship with the CMS (Council of Medical Schemes)
  • Signing off communication to the CMS
  • Overseeing the Special Committee Meetings and Appels from CMS
  • Maintaining good relationship with Bonitas Medical Fund
  • Overseeing all escalations and complaints raised with the Principal Officer
  • Motivation for change: Head Hunted
  • Achievement: Achieved and maintained the SLA monthly
  • No Penalties paid for missing the SLA's
  • 2 Of my Team Leaders promoted to Management positions
  • Two of my staff were winners on the staff Awards in 2012- 2013, One got the Platinum prize
  • In 2013 -2014 had 2 Team Leaders nominated as Finalists in Staff Awards
  • In 2014 - 2015 My Back Office was nominated as Finalist in Accountability Category

Contact Center Manager

Doves Financial Services- NUMSA Investment Companies Subsidiary
02.2011 - 07.2012
  • Managing Sales force, selling Funeral Insurance, Health Insurance
  • (Outbound Call Centre)
  • On the job coaching and training of subordinates
  • Data Analysis (Stats and formulating reports)
  • Assisting with complex queries
  • Managing complaints process for Doves Group
  • Managing Performance and development of agents
  • Ensured that ABSA /Numsa Strategic Alliance is affected efficiently
  • Ensured that sales agents are FAIS accredited
  • Motivation for change: Career development - Head Hunted
  • Achievement: Managed to establish the Call Centre
  • Groomed an agent to a team leader in the department
  • My Team leader now a Manager of the Call Centre I established

Call Centre Manager

Thebe Ya Bophelo Healthcare Administrators
06.2008 - 01.2011
  • Ensure that the company Balance Score Card is achieved
  • Ensure that the ISO processes are adhered to
  • Manage call centre agents plus a receptionist
  • Performance management of staff, to ensure that the KPI's are achieved
  • Ensure that the department is operating within set Budget
  • Ensure staff development by Multitasking & organization of training
  • Recruitment & Induction of new staff
  • Ensure that Good Client relationship is maintained
  • Attend to escalated queries and complaints (telephone/correspondence)
  • Formulation & analysis of reports to be presented to the COO, CEO & BOT
  • (Chief Operations Officer, Chief Executive officer & Board of Trustees)
  • Assisting Disease Manager with processes within the department
  • Motivation for change: Career development
  • Achievements: Managed to train two interns now permanently employed
  • Groomed an agent to a team leader in the department now a manager at another company
  • One of my agents was the recipient of the best employee in Thebe Investment Company (TIC)

General Support Supervisor

Bytes Healthcare Solutions/ Digital Healthcare Solutions
07.2006 - 05.2008
  • Maintain good client relationship
  • Monitor and manage staff performance
  • Formulating and analysing reports
  • Handling management calls and escalated queries
  • Ensuring excellent customer service is always rendered
  • Training new recruits and On the Job training of agents
  • Monitoring and ensure that service level agreement is adhered to
  • Conducting Interviews for new staff
  • Counselling and Disciplining staff
  • Grooming of agents
  • Motivation for change: Career development
  • Achievements: Managed to improve service level from 47% to 85% and abandoned rate from 27% to 2%
  • My team has an area of growth by introducing levels of seniority in the call centre

Customer Service Supervisor

African Health
10.2004 - 06.2006
  • Supervision of staff
  • Maintaining client relationship
  • Ensuring member retention
  • Supervision of Receptionist & switchboard
  • Standing in for Customer Service Manager
  • Assisting in doing Budgets for the department
  • Motivation for change: Company was relocating to Centurion
  • Wanted to broaden my Horizon in healthcare
  • Achievements: Managed to build a fully fleshed customer call centre department
  • Managed to maintain service level of >85%
  • Had an input in the new CRM system and was implemented

Call Centre Supervisor

Medpharm- Medscheme Subsidiary
06.1996 - 09.2004
  • Supervision of staff as above
  • Responsible for recruiting and training new agents
  • Team coach (February 1999- to March 2000)
  • Mainly on the job training
  • Coaching of other agents
  • Handling of difficult clients
  • Assessing of complicated claims
  • Handling priority queries
  • Motivation for change: Left for career advancement
  • Achievements: Was nominated Employee of the year for two consecutive years (1998-1999)
  • Was promoted to Team Coach (1999- 2000)
  • Further promoted to Call centre Supervisor Position (2000)
  • Selected to do recruitment & training of new staff (from 7 Supervisors)

Professional Nurse

Baragwanath Hospital
02.1991 - 05.1996
  • Patient Care
  • Assessing, observing and speaking to patients
  • Recording details and symptoms of patient medical history and current health
  • Preparing patients for exams and treatment
  • Administering medications and treatments, then monitoring patients for side effects and reactions
  • Creating, implementing, and evaluating patient care plans with the medical team
  • Performing wound care, such as cleaning and bandaging them
  • Assisting in medical procedures as needed
  • Operating and monitoring medical equipment
  • Drawing blood, urine samples, and other body fluids for lab work
  • Educating patients and family members on treatment and care plans, as well as answering their questions
  • Supervising student nurses, Nurses, Nursing Assistants and General workers
  • Motivation for change: Needed further professional growth and to broaden my healthcare Horizon

Student Nurse

Baragwanath Hospital
02.1987 - 01.1991

Teacher

Shongwe High School
05.1986 - 12.1986
  • Private teaching whilst on waiting list to go to Baragwanath (6 months)
  • Motivation for change: Got a call up for Nursing Training

Summary

Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.

Education

High School Diploma -

Shongwe High Scool
Mpumalanga Formerly Eastern Transvaal
01.1978 - 12.1985

Diploma in Nursing ( General, Community, Psychiatric) And Midwifery - Nursing Science

Baragwanath Nursing College
Soweto Johannesburg
02.1987 - 01.1991

No Degree - HIV Counselling

Baragwanath Hospital
Soweto Johannesburg
03.1991 - 03.1991

Certificate in Industrial Psychology - Industrial Psychology

Home Study College
Cape Town
02.1995 - 11.1995

Post Graduate Diploma in Business Management - Business Management

MANCOSA
Johannesburg & Durban
01.2022 - 12.2023

Skills

  • Multitasking proficiency
  • Regulatory compliance
  • Conflict resolution techniques
  • Strategic planning expertise
  • Interdepartmental collaboration
  • Professional networking
  • Project management experience
  • Organizational leadership
  • Medical terminology proficiency
  • Team building and motivation
  • Patient care coordination
  • Quality improvement initiatives
  • Healthcare administration
  • Data analysis
  • Operations management
  • Staff development
  • Human resources management

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Affiliations

  • South African Nursing Council

Work Preference

Work Type

Full TimePart TimeGig Work

Work Location

On-SiteRemoteHybrid

Important To Me

Career advancementWork-life balancePaid time offPaid sick leaveFlexible work hoursPersonal development programsHealthcare benefitsWork from home optionCompany Culture

Quote

The solution of a problem is in the problem
annonymous

Software

Microsoft Office

SAP

Various CRM systems ( Rockwell ,MIP, Nexus,)

Languages

English
Bilingual or Proficient (C2)
Afrikaans
Elementary (A2)
Xhosa
Upper intermediate (B2)

Interests

Reading

Christianity

Watching Soccer/ Sports

Timeline

Hospital Benefit Management

Universal Healthcare
02.2023 - Current

Post Graduate Diploma in Business Management - Business Management

MANCOSA
01.2022 - 12.2023

Operations Manager- Contact Centre

RX Health
08.2021 - 05.2023

Bonitas Client Operations Manager- Administration Support/ Back Office

Medscheme Holdings Pty (Ltd)
07.2012 - 07.2021

Contact Center Manager

Doves Financial Services- NUMSA Investment Companies Subsidiary
02.2011 - 07.2012

Call Centre Manager

Thebe Ya Bophelo Healthcare Administrators
06.2008 - 01.2011

General Support Supervisor

Bytes Healthcare Solutions/ Digital Healthcare Solutions
07.2006 - 05.2008

Customer Service Supervisor

African Health
10.2004 - 06.2006

Call Centre Supervisor

Medpharm- Medscheme Subsidiary
06.1996 - 09.2004

Certificate in Industrial Psychology - Industrial Psychology

Home Study College
02.1995 - 11.1995

No Degree - HIV Counselling

Baragwanath Hospital
03.1991 - 03.1991

Professional Nurse

Baragwanath Hospital
02.1991 - 05.1996

Diploma in Nursing ( General, Community, Psychiatric) And Midwifery - Nursing Science

Baragwanath Nursing College
02.1987 - 01.1991

Student Nurse

Baragwanath Hospital
02.1987 - 01.1991

Teacher

Shongwe High School
05.1986 - 12.1986

High School Diploma -

Shongwe High Scool
01.1978 - 12.1985

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