About the Role
Chedid Capital Group is a leading investment group in the (re)insurance industry with an extensive presence of 80-plus subsidiaries, powered by 1,700-plus employees across more than 85 countries in Europe, the Middle East, Africa, and Asia.
Through its diverse portfolio spanning (re)insurance, risk advisory, and education, the Group has built one of the industry's most dynamic networks, combining global scale and local market expertise.
Ascoma Insurance Advisor & Broker, a company of Chedid Capital Group, is looking for a Senior TPA Operations Monitoring Officer who will be responsible for monitoring and improving operational processes across the Group’s Health TPA activities, ensuring compliance with procedures and service standards, while driving operational efficiency, performance and quality across subsidiaries.
Responsibilities
- Evaluate and analyse operational processes across the entire Health TPA lifecycle, including membership and benefits management, pre-authorisations, claims, billing, payments, complaints and fraud prevention, identifying risks and areas for improvement.
- Ensure that operations comply with Group procedures, internal guidelines, client SLAs and contractual agreements, and follow up on Internal Audit recommendations.
- Monitor operational performance, transaction quality, data reliability and cost control, identifying discrepancies and coordinating corrective actions with subsidiaries.
- Define and monitor performance and control indicators (KPIs), establish reporting standards and ensure regular follow-up of critical indicators.
- Analyse and optimise existing processes, propose process reengineering initiatives and implement improvements to enhance operational efficiency, service quality and risk management.
- Design, document and maintain efficient operational workflows, clearly defining roles, responsibilities, timelines, control points and escalation procedures.
- Coordinate with subsidiaries on operational action plans and IT transformation projects, including functional testing, issue resolution and the deployment of new systems.
- Contribute to the development and harmonisation of Group operational procedures and manuals, deliver training to subsidiary teams and travel to African subsidiaries when required.
Requirements
- Bachelor's degree in Healthcare, Nursing, Insurance, Business Administration or a related field.
- Minimum 6 years of experience in health insurance services, preferably in Health TPA operations.
- Experience in process improvement or reengineering.
- Fluency in French and English, both written and spoken.
- Good knowledge of healthcare management systems, KPIs and quality control.
- Willingness to travel to African subsidiaries when required.
