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Care Manager

Main Responsibilities

  1. Obtaining daily reports of admissions in the various service providers
  2. Broker/customer communications by communicating as necessary admission claim decisions on a timely basis
  3. Care Management – Through due diligence, ensuring undertakings are issued in line with the policy provisions. Likewise for
    declines, ensuring that the decisions are accurate
  4. Fraud mitigation – Implementing fraud mitigation strategy for the company.
  5. Provider relationship management – Ensuring strong provider relationships to enhance provider and customer experience.
  6. Visiting of patients at the various service providers, obtaining details of patients to confirm that admitted members are the
    eligible policy holders/ dependents
  7. Confirming that the treatment the member is given is covered by the policy purchased
  8. Ensuring that the medical reports in the hospital are accurate and reflective of what is provided to the insurer and also
    confirm what the member understands or communicates
  9. Ensuring proper care and treatment of patient within acceptable protocols without wastage by member/ provider
  10. Reviewing medical pre-authorizations for compliance with applicable policy guidelines and giving guidance to the other care
    management team on any information collected during the visits to the hospitals
  11. Interacting with clients, brokers and clinicians as needed, to resolve problems in a manner that is legal, ethical and consistent
    with the principles of the policy
  12. Obtaining medical information from providers with written correspondence if necessary.
  13. Checking and confirming membership validity and benefits (from the scheme benefits file)
  14. Handling of coverage enquiries with brokers, providers, members.
  15. Vetting and confirming validity of the service given by the service provider in relation to the benefits covered, treatment
    given, adherence to provider panel rules and cost of treatment
  16. Obtaining additional required information on claims from providers, brokers or clients
  17. Liaising with our underwriting section on scope of cover for various schemes
  18. Assisting in conducting provider audits wherever necessary.
  19. Client presentations and member education on wise utilization & risk management
  20. Managing the 24-hour emergency helpline
    Key Competencies
  21. Passionate, Goal driven and results oriented.
  22. Strong organizational and analytical skills.
  23. Strong Problem-solving skills.
  24. Communication skills
  25. Team Spirit
  26. Strong interpersonal & relations skills

Qualifications

  1. Degree/ Diploma holders preferably in clinical studies (nursing)
  2. University Graduate in a relevant field will be an added advantage
  3. Proficient in the use of Microsoft Office suite & packages (Word, Excel, PowerPoint and Vision)
  4. Basic understanding of the concepts of insurance

Assistant Accountant

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Job Ref. No. JLIL061

Main Purpose of the Job (Job Summary)

  • The role holder will undertake reconciliations of Bank and General Ledger accounts. The role holder will also be responsible for receipting and dispatch of receipts to customers.

Main Responsibilities

  • Preparation of Bank and General Ledger Accounts reconciliations, investigate and clear all reconciling items

Academic Qualifications

  • Bachelor’s degree in a business-related course
  • CPA Section 4
  • Computer skills- Proficiency in MS Office Suit
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Key Competencies

  • Attention to detail
  • Analytical skills
  • Reconciliation Skills
  • Ownership & Commitment
  • Team Spirit
  • Communication Skills

IFRS17 Actuarial Associate

Job Ref. No. JLIL059

Main Purpose of the Job (Job Summary)

The role holder will work within the IFRS17 workstream, with the responsibility for technical modelling and actuarial computations, implementation within strict timelines, system set-up, user acceptance testing, dry run & go live.

Main Responsibilities

IFRS17 transition and reporting

  • Technical modelling, actuarial computations, and reporting under IFRS17 methods.
  • Develop controls, model audit trails, validation and documentation around estimates and judgement in IFRS17
  • implementation for data & results consistency, completeness, and accuracy.
  • Modelling Jubilee financial statements under IFRS17 basis and comparatives to IFRS4.
  • Testing products to examine their technical & operational feasibility under IFRS17.

System set-up

  • Setting up product models and reporting on actuarial & IFRS17 software
  • User Acceptance Testing

Projections and Budgeting

  • Projected actuarial cash flows under IFRS17 budgets

4Financial & regulatory reporting

  • Inputs to regulatory reports i.e., Financial Condition Report, Solvency, Risk Based Capital reports
  • Support stakeholders with actuarial inputs: Finance, appointed actuary and audit/ assurance teams on IFRS17 reporting within monthly, quarterly & end year reporting timelines

Profit testing

  • Profit-testing of products under IFRS17 and recommendations on optimal treatment of onerous contracts
  • New product development & reporting: Technical analysis under IFRS17

Actuarial analyses

  • Analysis of Jubilee’s value of new business, embedded value & Asset Liability Management valuations
  • Risk assessment, management, and reporting under IFRS17 reporting

Key Deliverables

  • Fulfill IFRS17 implementation for the region
  • Appropriate pricing to achieve target profit criteria set by executive management
  • Actuarial reporting for regulatory compliance & financial statements.

Academic Qualifications

  • Bachelor’s Degree in Actuarial Science, Statistics, Mathematics or any other related field
  • Professional actuarial exams (associate under IFOA/SOA or equivalent) is a mandatory requirement
  • Accounting qualification will be an added advantage

Key Competencies

  • Entrepreneurial Spirit
  • Market Awareness
  • Customer Focus
  • Continuous Innovation
  • Ownership & Commitment
  • Team Spirit

Experience

  • Minimum of three (3) years’ relevant experience, one (1) of which is at a supervisory level.

Data Governance Manager

Job Ref. No. JLIL062

Main Purpose of the Job (Job Summary)

  • The role holder will define, implement, and ensure adherence to the company wide Data Governance framework and policies across all domains to drive and improve data quality and integrity to support decision making and drive growth.

Main Responsibilities

  • Establish and govern an enterprise data governance implementation roadmap including strategic priorities for development of information-based capabilities aligned to best practice and international standards across all business
  • domains e.g., DAMA, ARMA, DCAM
  • Responsible for defining and driving governance to ensure implementation and adherence to data governance policies defined including big data platforms and cloud implementations.
  • Define roles and responsibilities related to data governance and ensure clear accountability for stewardship of the company’s principal information assets
  • Identity and drive business use of data assets to stimulate growth through insights and analytics
  • Define tools and methods to implement and drive adherence to data governance policies
  • Proactively engage in new products design, system deployments and lines of business to ensure data governance is implemented at the core of all new initiatives
  • Input into the Group to drive global best practices on Data Governance across all group operations and partner markets
  • Ensure adherence to data privacy across all key data domains as defined by the company’s data privacy policy and in line with the regulations
  • Implement systems and process for Monitoring data quality process, identifying data quality issue patterns, applying
  • remediation plans, implementation of data controls, and manage data quality remediation strategies.
  • Define indicators of performance and quality metrics (KQIs) and ensure compliance with data related policies, standards, roles and responsibilities, and adoption requirements

Academic Qualifications

  • Bachelor’s degree in management, organization governance, information management, or any other related management field.

Key Competencies

  • Ability to think creatively, highly driven, and self-motivated
  • Strategic perspective with an ability to analyze complex issues, develop appropriate action plans and deliver results.
  • Ability to synthesize and analyze diverse data and information, develop, and recommend strategies

Experience

  • A minimum of three (3) years of experience in an enterprise data governance business environment.
  • Any IT management certification, such as ITIL, will be an added advantage.
  • Experience with SQL is strongly preferred.

Method of Application

If you are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting the Job Reference Number and Position by 23rd May 2022. Only shortlisted candidates will be contacted.

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