Jobs Kenya

Company Address: Address Antwerpen

  • Claims Representative

    Claims Representative

    Main Duties/Responsibilities:  

    Adjudicate international medical/dental and vision claims in accordance with policy terms and conditions to meet personal and team productivity and quality goals. 
    Monitor and highlight high cost claims and ensure relevant parties are aware. 
    Monitor turn around times to ensure your claims are settled within required time scales, highlighting to your Supervisor when this is not achievable. 
    Respond within the time commitment given to enquiries regarding plan design, eligibility, claims status and perform necessary action as required, with first call resolution where possible. 
    Interface effectively with internal and external customers to resolve customer issues. 
    Identify potential process improvements and make recommendations to team senior. 
    Actively support other team members and provide resource to enable all team goals to be achieved. 
    Work across European business in line with service needs. 
    Carry out other adhoc tasks as required meeting business needs.

    Experience Required: 

    Customer focused with ability to identify and solve problems.
    Ability to meet/exceed targets and manage multiple priorities. 
    Proficient in Microsoft Office applications. 
    Preferred if English and Arithmetic qualification gained. 
    Experience in medical administration, claims environment or Contact Centre environment is advantageous but not essential. 

    Skills: 

    Must possess excellent attention to detail, with a high level of accuracy. 
    Strong interpersonal skills with good verbal and written communication to internal and external clients. 
    Strong customer focus with ability to identify and solve problems. 
    Ability to work under own initiative and proactive in recommending and implementing process improvements. 
    Ability to organise, prioritise and manage workflow to meet individual and team requirements 
    Ability to exercise judgement.

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • IAM Control Operations Analyst

    IAM Control Operations Analyst

    Mission Statement 

    At Cigna, we’re more than a health insurance company. We’re a global health service company. Identity and Access Management is an integral part of IT whose mission is to enforce the principle of Least Privilege through regular Reviews and other Technical Access Controls while preserving Compliance for testing by external auditors.

    Essential Duties and Responsibilities

    The Identity Governance Management Analyst will be responsible for the design, development, and execution of Identity Access Reviews, Entitlement Management, and RBAC. Access Controls are operated to enforce the principle of Least Privilege and meet stringent regulatory requirements. These controls are tested by external auditors for accuracy and completeness which requires flawless and consistent execution. The Identity Governance Management Analyst will also be responsible for building and presenting control execution evidence to auditors while looking for opportunities to improve control execution for improved completeness, accuracy, and efficiency.
    You will work from our Nairobi offices, in close collaboration with team members in the UK and Kuala Lumpur. We expect you to work at least 40% from a Cigna office, the rest of the time you can work from home.
    You will be involved in the transition from RSA Lifecycle and Governance to Saviynt Cloud.

    Responsibilities include, but are not limited to, the following:

    Assess authentication and authorization schemas with application/system (SME) Subject Matter Experts.
    Educate system SMEs on the regulatory eco-system and communicate how individual applications and systems interact with each other.
    Assist systems owner SMEs in the identification of regulatory scope in their environment. This includes but is not limited to identifying environments, servers, user population, system functions, and permissions.
    Document positive and negative attestation of system scope.
    Document in-scope accounts and their effective permissions in preparation for Access Reviews.
    Analyze the business need of current accounts and effective permission sets.
    Support the design, implementation, and use of Entitlement Management capabilities in Access Management tools.
    Upload system data into Identity Governance tools.  (Identity what data is uploaded. Validate the correctness of the data. Check frequency data gets renewed.)
    Execute Access Reviews manually and within Identity Governance tools. Manage user, privileged, and Service Accounts
    Support provisioning and termination controls
    Document and maintain Standard Operating Procedures

    Job Specific Core Competencies

    Hands-on experience in Identity and Access Management tools such as Saviynt and RSA Lifecycle and Governance, CyberArk, and Active Directory
    Experience with application entitlements and Role Based Access Controls
    Knowledge/Experience in SOX/SOC1/SOC2 Compliance Controls and information security best practices
    Experience with soliciting and documenting detailed business/audit requirements
    Basic experience working in the fields of Identity and Access Management and Privileged Access Management.
    Active Directory
    SQL – Oracle
    Okta
    Familiar with managing stories on Jira boards
    Excellent written and verbal communication skills with a customer focus. Ability to work with a variety of internal and external stakeholders
    Supportive, customer focused
    Reporting and documentation
    Proactive and positive mindset

    Education/Experience Requirements

    Education

    Bachelor degree in Computer Science, Cyber Security, Information Technology, Information Sciences, or equivalent educational or professional experience and/or qualifications

    Work Experience

    2 years experience in all aspects of computer operations or an equivalent combination of education and work experience
    Preferred: 2-4 years in developing, implementing, and/or operating IAM systems and controls

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Customer Service Representative – Portuguese Speaking

    Customer Service Representative – Portuguese Speaking

    About the job

    Handle calls and e-mails and respond to simple and complex inquiries regarding eligibility, cards status, Envoy registration/navigation, policy benefits, issue certificates of insurance, claims status and other related information and provide solutions for customers and clients.
    Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, clients, brokers and/or others. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. May seek assistance with complex customer services issues.

    Qualifications

    Must have a Diploma or Bachelor’s degree or equivalent
    Excellent English and Portuguese written and oral communication skills is a Must
    Exceptional organizational and time-management focus
    Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
    1+ years of customer service experience analyzing and solving customer problems required; call center experience a PLUS
    Ability to perform in a high volume, fast paced call center environment
    Proven ability to work independently as well as a productive member of a team
    Intermediate proficiency in Microsoft Office Suite; high level capacity to multitask independently and on a computer
    Knowledge of Medical Terminology a PLUS

    Conditions/Requirements

    Work in 24 x 7 rotation shifts.
    5 days a week.
    In split shifts (some hours in the morning and remaining hours in the afternoon or evening) and Public Holidays

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Customer Service Representative – Arabic Speaking

    Customer Service Representative – Arabic Speaking

    Description

    Arabic Speaking Customer Service Representative (Calls and Email Team)
    Handle calls and e-mails and respond to simple and complex inquiries regarding eligibility, cards status, Envoy registration/navigation, policy benefits, issue certificates of insurance, claims status and other related information and provide solutions for customers and clients.
    Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, clients, brokers and/or others.  Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. May seek assistance with complex customer services issues.

    Qualifications

    Must have a Diploma/ Bachelor’s degree or equivalent
    Must have excellent English and Arabic written and oral communication skills
    Exceptional organizational and time-management focus
    Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
    1+ years of customer service experience analyzing and solving customer problems required; call center experience a PLUS
    Ability to perform in a high volume, fast paced call center environment
    Proven ability to work independently as well as a productive member of a team
    Intermediate proficiency in Microsoft Office Suite; high level capacity to multitask independently and on a computer
    Knowledge of Medical Terminology a PLUS

    Conditions/Requirements:

    Work in 24 x 7 rotation shifts.
    5 days a week.
    In split shifts (some hours in the morning and remaining hours in the afternoon or evening)
    During public holidays

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Provider Claims Intake Administration Senior Supervisor Customer Service Representative Portuguese Speaker General Clerk Associate Representative Claims Supervisor General Clerk Associate Representatives/Administrative Assistants

    Provider Claims Intake Administration Senior Supervisor Customer Service Representative Portuguese Speaker General Clerk Associate Representative Claims Supervisor General Clerk Associate Representatives/Administrative Assistants

    YOUR JOB

    As an Intake Senior Supervisor you will take up a management position. You will be responsible for managing the Back-end Intake area of our Provider Services Organization. This area will count with 2 teams sitting in Nairobi and 1 in Kuala Lumpur supported by 3 Intake Supervisors, responsible for circa 55 FTE.
    Your role will be broader than the day-to-day management of the intake operations – your agile, provider centric mindset will ensure that you contribute to our overall provider operations strategy, identifying opportunities to enhance the service proposition and to improve the efficiencies and productivity of your teams. Your role will report into the PSO Intake & Reconciliation Manager.

    Your role will be to:

    Motivate individuals and team collectively to achieve agreed productivity, turn-around-time, quality target linked to the intake process
    Create an environment that encourages and delivers success – you must have the ability to inspire your team whilst developing your team members to the next level
    Collaborate closely with other areas in PSO – Front and Back End: Provider Relations, Care, Reconciliation, Claims & Adjustment teams
    Ensure appropriate performance management action, timely recruitment and effective succession planning is in place
    Contribute to change and innovation and be pro-active in identifying opportunities for improvement within the team and within Provider claims Intake processes
    Use data insights to challenge day-to-day operations, and build a continuous improvement mindset
    Manage effective capacity plans, keeping oversight of staff level requirements.  Proactively address and escalate any risks
    Produce meaningful, accurate management reports and statistical information in line with formats and timescales agreed with management, including trending and enhancement activities to quantify operational impacts
    Manage the implementation of running and new projects related to provider claims intake
    Develop and maintain proactive business relationships, both internally and externally to ensure a seamless delivery of service 
    Be a focal point for the PSO leads as well as other internal stakeholders
    Interact with the senior management to adapt your processes to meet evolving objectives
    Use independent judgement and discretion to review and resolve complex issues
    Contribute in achieving departmental and company-wide goals and business plans

    YOUR PROFILE

    Experience leading operational teams within the company or outside
    Current provider claims intake process deep knowledge
    Active participation in provider claims intake related projects
    Exposure to global processes (e.g. provider reconciliation)
    Active language knowledge of at least English (additional languages are a plus)
    Experience in coaching, managing, developing and motivating individuals
    Proven data analytics skills (advanced Excel, Qlikview, Tableau …) 
    Clear experience in driving a team to achieve excellent provider service results
    Experience of leading and implementing change
    Excellent inter-personal skills
    Negotiation and influencing skills
    Action-orientated problem-solving skills / process improvement
    Excellent organisation, planning and prioritisation skills
    Strong communication skills: demonstrating drive and enthusiasm
    Demonstrating flexibility and adaptability to change
    Result-oriented, able to mobilise the team to achieve key objectives
    Accountability – assumes ownership for achieving personal results and collective goals
    Customer orientated

    KEY COMPETENTIES

    Manage ambiguity
    Balances stakeholders
    Organizational Savvy
    Drives Engagement
    Build effective teams
    Tech savvy
    Global perspective
    Data driven

    go to method of application »

    Use the link(s) below to apply on company website.  

    Apply via :

  • Senior Case Management Supervisor Receptionist / Administrative Services Senior Representative

    Senior Case Management Supervisor Receptionist / Administrative Services Senior Representative

    YOUR JOB

    Motivate individuals and team collectively to achieve agreed work output targets covering productivity, quality and customer/provider satisfaction
    Recommend and implement innovative strategies to ilig all three different segments, improve efficiency and provide excellent customer service.
    Be proactive in identifying improvement/enhancement opportunities and active in seeking and sharing ideas for innovation in business processes within the Integrated Health Team and other operations; recommend and implement innovative strategies to improve efficiency within the pre-authorization and care coordination process and provide excellent customer service, including to members, clients, but also health care providers.
    Ensure strong employee engagement within the team, including day to day oversight, motivation, conflict management, training, well being and performance
    Performed quarterly check-in and career development talks. Ensure appropriate performance management actions are taken
    Proactively address and/or escalate any risks.
    Develop/maintain proactive/effective business relationships, both internally and externally to ensure a seamless delivery of service.  Actively encourage all team members to do likewise.
    Produce, review and interpret reporting and data in line with formats and timescales agreed with management, including trending and enhancement activities with quantification of operational impacts.
    Ensure work planning is complete and be first line of approval for holidays within your team. Lies with other supervisors and manager for find approval.
    Escalation point for complex cases a, complaint  and financial verification and exceptional payment
    Key contact with Teladoc for escalated cases
    Handle complex  complaint cases, perform root cause analysis and report to CCM team manager.

    YOUR PROFILE

    Minimum of three years  experience in an operational team
    Active language knowledge of at least English; any additional language is a plus
    Experience and/or interest in coaching, managing, developing and motivating individuals
    Experience in complaint management – with a proven track record in improving customer service standards
    A growth mindset with a positive attitude towards change and the ability to play an active role in implementing change initiatives.
    Excellent interpersonal skills: strong empathy and listening skills
    Competency to build a team and create an atmosphere of positive collaboration, innovation and creative solutioning among the team members
    Action-orientated problem-solving skills
    Excellent organization, planning and prioritization skills
    Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues
    Personal flexibility and adaptable to change
    Results oriented– ability to define goals, establish plans and manage work to achieve desired outcomes. Creates meaningful business related metrics and tracks progress/results.
    Accountability – assumes ownership for achieving personal results and collective goals
    This is a band 3 higher function

    go to method of application »

    Use the link(s) below to apply on company website.  

    Apply via :

  • Senior .NET Developer – Apollo

    Senior .NET Developer – Apollo

    Your responsibilities

    Together with the team, you support requirement definition, and transform and develop these requirements into an appropriate architecture and solution. 
    You have end-to-end responsibility for backend applications that support our claims handling processes.
    Write automated unit and integration tests.
    Formulate & propose improvements, both on functional and technical level.
    Define technical guidelines.
    Document the implemented architecture and solution.
    Deliver quality code, whilst keeping deadlines and business value in mind.
    Work together in an international, cross-functional scrum team and the wider International Health organization.
    Have a proactive role within the development chapter across all IGO/NGO scrum team.

    Don’t worry, you don’t have to do this alone; you will work closely with the other developers, the Product Owner, Scrum Master, Subject Matter Experts and testers in your scrum team. You will be supported by the internal customer and our architects. On top of that, you are supported by the Developer Chapter, the group of .NET developers working in all IOH teams.

    Your Profile

    We value traits like an agile mindset, passion & positivism. We are looking for colleagues who take responsibility and want to make a difference. To collaborate in an international environment, English language skills are required (written and spoken).

    General requirements

    You have a Bachelor or Master degree in IT.
    You have a excellent knowledge of written and spoken English and are a strong communicator.
    You are able to articulate and bring structure in your ideas and solutions.
    You have 5 or more years of experience in .NET (backend) development.
    You are able to convert functional analysis into technical design and estimates, working with our Architecture team.
    You are able to work both independently and as part of a close knit team.
    You are eager to work on bespoke .NET components, as well as customize and configure imaging & workflow vendor platforms.
    You demonstrate strong communication, prioritization, organization and problem solving skills.
    You enjoy driving solutions from conception to release. 
    You have a customer oriented, creative and inventive mindset.
    You have strong motivational and convincing skills
    You are sensitive to cultural differences and you enjoy working in a global, multi-location team.
    You are able to deal with ambiguity.

    Essential technical skills

    Development in .NET and MS SQL using Visual Studio

    Experience in any of the following is a big plus

    Previous experience with Agile methodologies (SAFe, SCRUM, …) 
    Experience with ORM Frameworks, Enterprise Library, NuGet, WCF 
    Experience with ALM/DevOps tooling (eg. Azure Devops Pipelines)
    Experience with Windows Server infrastructure (including IIS)
    GIT or TFS version control systems

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Senior Client Manager International Organizations

    Senior Client Manager International Organizations

    Responsibilities

    Be the primary point of contact and person of trust for your clients
    Monitor swift implementation of new clients/services
    Build client intimacy and maintain excellent working relationships with the various key stakeholders of the client
    Provide consultative guidance to clients
    Maximize client retention by negotiating contract renewals at sustainable rates
    Learn and self-develop continuously through trainings and other learning opportunities
    Participate actively in various internal projects, contributing to organisational strategy and organisational learning
    Pro-actively identify and pursue up- and cross-sell opportunities
    Align the company’s service proposition to the client’s needs while ensuring operational efficiency
    Coordinate complaint and problem resolution with other departments

    Profile/Skills

    5 years experience or more in relationship/account management in Employee Benefits, Financial Services or Consulting, preferably in an international context (ideally with IOs)
    Sound knowledge of Excel, Word, PowerPoint. Experience with Access is a plus
    Strong technical skills including affinity with collation of data and statistical analysis. Ability to do back of the envelope underwriting calculations or legal reasonings.
    Excellent knowledge of English and French. An additional language is a plus (Spanish, German, Arabic)

    Most important competencies for this role

    Excellent communication skills, written and verbal
    Autonomous, strong organisational skills
    Flexible and stress resistant
    Empathic, honest, sincere and authentic
    Sociable: correct, professional and at ease in contact with different stakeholders
    Team player, sense of responsibility and ownership
    Appreciation and respect for different perspectives and cultures
    Listens attentively and responds non-defensively when given advice, instruction, or feedback
    Maintains an open, friendly, and accepting demeanor when interacting with others
    Takes on work and assignments with enthusiasm and a can-do attitude
    Demonstrated ability to manage a considerable crisis or important challenge in an independent and efficient manner
    Demonstrated ability to handle complex clients fully autonomously, while relying on the support of specialised teams in the company, in a sustainable and correct way 
    Pro-active and strategic thinker, taking into account the impact of decisions on the entire business segment (rather than his/her own client portfolio).

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Case Management Associate Analyst

    Case Management Associate Analyst

    MAJOR RESPONSIBILITIES

    Part of a clinical team that provides medical management services to customers worldwide but mainly in Africa region.
    Give evidence-based advice on pre-authorization, considering internationally accepted protocols and local and/or regional customs and regulations.
    Assessing pre-authorization requests claims in line with the policy coverage and medical necessity. 
    Identify and refer cases to the Cigna Clinical team for case management, disease management and other clinical services 
    Assist and support the team in cost containment, assist in projects and service delivery to meet goals. 
    To assist queries from providers and payers via phone calls or e-mails 
    Be fully versed with medical insurance policies for various groups / beneficiaries. 
    Might be required to assist in training colleagues and sharing knowledge. 
    Ability to review, investigate, and respond to external and internal inquires/complaints and provide guidance to other clinical and non-clinical staff related to medical necessity. 
    Assist in fraud detection
    Meeting the defined qualitative and quantitative key performance metrics for the assigned job role. 
    Ensure adherence to the predefined TATs for pre-approvals 
    Achieving required targets assigned by the team leader on daily, weekly, and monthly basis. 
    Ensure compliance to any changes in terms of system parameters or process. 
    Other duties as assigned

    REQUIREMENTS

    University degree of Medical /Nursing specialization with international healthcare experience.  
    2-3 years of clinical experience preferable in a payer setting on medical management.
    Experience in the Africa region & International market
    Fluent in English along with either French, Portuguese or Spanish, any other language is a plus
    Strong interpersonal and communication skills. 
    Must be a computer literate
    Knowledge of utilization, cost containment services, insurance coverage.
    Ability to build solid working relationships with staff, clients, customers, and healthcare providers. 
    Demonstrates pro-active problem-solving and analytical skills 
    Ability to work under pressure and meet tight deadlines 
    Flexible to work on shifts/varying work schedules.

    Apply via :

    cigna.wd5.myworkdayjobs.com

  • Senior Case Management Supervisor

    Senior Case Management Supervisor

    YOUR JOB

    Motivate individuals and team collectively to achieve agreed work output targets covering productivity, quality and customer/provider satisfaction
    Recommend and implement innovative strategies to ilig all three different segments, improve efficiency and provide excellent customer service.
    Be proactive in identifying improvement/enhancement opportunities and active in seeking and sharing ideas for innovation in business processes within the Integrated Health Team and other operations; recommend and implement innovative strategies to improve efficiency within the pre-authorization and care coordination process and provide excellent customer service, including to members, clients, but also health care providers.
    Ensure strong employee engagement within the team, including day to day oversight, motivation, conflict management, training, well being and performance
    Performed quarterly check-in and career development talks. Ensure appropriate performance management actions are taken
    Proactively address and/or escalate any risks.
    Develop/maintain proactive/effective business relationships, both internally and externally to ensure a seamless delivery of service.  Actively encourage all team members to do likewise.
    Produce, review and interpret reporting and data in line with formats and timescales agreed with management, including trending and enhancement activities with quantification of operational impacts.
    Ensure work planning is complete and be first line of approval for holidays within your team. Lies with other supervisors and manager for find approval.
    Escalation point for complex cases a, complaint  and financial verification and exceptional payment
    Key contact with Teladoc for escalated cases
    Handle complex  complaint cases, perform root cause analysis and report to CCM team manager.

    YOUR PROFILE

    Minimum of three years  experience in an operational team
    Active language knowledge of at least English; any additional language is a plus
    Experience and/or interest in coaching, managing, developing and motivating individuals
    Experience in complaint management – with a proven track record in improving customer service standards
    A growth mindset with a positive attitude towards change and the ability to play an active role in implementing change initiatives.
    Excellent interpersonal skills: strong empathy and listening skills
    Competency to build a team and create an atmosphere of positive collaboration, innovation and creative solutioning among the team members
    Action-orientated problem-solving skills
    Excellent organization, planning and prioritization skills
    Able to seek out best practice in order to effectively deal with diverse, complex and highly sensitive issues
    Personal flexibility and adaptable to change
    Results oriented– ability to define goals, establish plans and manage work to achieve desired outcomes. Creates meaningful business related metrics and tracks progress/results.
    Accountability – assumes ownership for achieving personal results and collective goals
    This is a band 3 higher function

    Apply via :

    cigna.wd5.myworkdayjobs.com