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Fraud Team Leader
Firstrand Namibia LimitedJohannesburg, Gauteng, South Africa10 days ago
Job descriptionMinimum of 3 years experience in Operational Risk Management. Banking experience preferred Develop and implement a comprehensive evidence-based oncology risk management strategy that drives the provision of cost-effective care while improving health outcomes. The strategy must span the needs of the full scheme population including screening and prevention, cost-effective treatment across the full episode of care (in and outpatient treatment and care), and appropriate care at end of life. Design and oversee care coordination programmes for multi-morbid members with high healthcare utilization. Champion shared value (value-based care, alternative reimbursement models and guaranteed savings), quality measurement (including PROMS and PREMS), preventive health strategies, personalized care and innovative models Lead cross-functional collaboration across the business, including close collaboration with CCE, operations, risk intelligence and the health professional unit, in order to pull together different initiatives into a single coherent strategy that achieves the PHM objectives while aligning with broader organizational goals. Provide thought leadership at industry level and across the Discovery business (e.g. Life, Vitality UK, Vitality SA, Ping An, Amplify Health) including providing support for the development of risk management strategies across the Discovery business. Present at leading conferences (e.g. Palliative Care conference, SA Society of Medical Oncologists, European Society of Medical Oncologists, ICON conference) Oversee the use of data analytics to identify trends, monitor risks and assess opportunities Analyse clinical and financial data to identify high-risk populations and cost-drivers Guide the development of dashboards and reporting tools to monitor health metrics and outcomes of initiatives Develop risk stratification frameworks and predictive models to guide interventions Guide data governance and sharing of data to empower stakeholders Direct Health Intelligence and Data Science Lab for the development of models that inform the design and guide the selection and initiation of appropriate interventions Partner with the R&D team to enhance current benefit design and design new scheme benefits Enhance existing products (e.g. Personal Health Pathways, Health ID) to support the risk management strategy Develop new products for cancer care with R&D in Health and other business units Continually scan for, research and assess digital solutions and other innovations that support the risk management strategy and / or improve experience Engage with clinical leaders, medical schemes, suppliers and regulatory entities. This engagement will be at senior executive level (e.g. principal officers, CEOs and senior executives, leaders of medical societies, leading academics) Build partnerships to drive adoption of oncology and care coordination initiatives Ensure adherence by oncologists to clinical guidelines and value-based principles Represent Discovery Health in external forums and policy discussions and provide thought leadership at industry level Keep abreast with relevant legislation and ensure that all stakeholders understand implications Manage contracting strategy across oncology facilities (chemotherapy and radiation therapy) Design and negotiate contract terms with corporate service providers Ensure that all stakeholders adhere to contractual obligations and all administrative matters pertaining to contracts are completed Consult on legal matters pertaining to contract management Senior SRM representative at the SRM / Ops oncology and care coordination forums Ensure that interventions are correctly implemented by relevant implementation and operational teams (including Functional Enablement, Discovery Care, Systems and Special Projects) Define KPIs and monitor performance of the operational teams against KPIs and ensure continuous improvement Oversee care coordination programmes for members with high resource requiring multi-morbidities (complex cases) including multidisciplinary case reviews, care planning and transititions of care Contract expert panels for multi-disciplinary review of oncology and complex cases Embed existing assets into solutions Medical qualification or a related health field Post graduate qualification would be preferred (e.g. Master's degree in Public Health, Health Economics, Health Policy, Health Administration, Population Health Management. Relevant healthcare professional body (e.g. HPCSA, SANC, SAPC) Certification / qualifications in analytics, behavioural economics / science and disease management (advantageous). Minimum 10+ years in managed care, clinical risk management or care coordination. Strong background in oncology risk management and complex case oversight. 3 -5 senior leadership experience. Proven track record of driving cross-collaboration design and implementation of health initiatives (advantageous). Good working knowledge of health analytics, clinical coding and reimbursement models (advantageous). Stakeholder management at senior executive level and communication skills (advantageous). Strategic planning and execution Data literacy and familiarity with health informatics Strong communication and stakeholder management Change management and innovation leadership Understanding of healthcare systems, policy and reimbursement models Managing multidisciplinary teams Public speaking / presentations Publication of research .CFA an added advantage CE8 to 10 year's relevant experience in Credit Risk / Finance / Investment Banking in a financial institutio ceKnowledge and understanding of credit risk and any associated risks prevalent in the financing of transactions / projects will be an advanta geExcellent analytical, verbal and written communication skil lsPreferred knowledge of regulations and compliance requirement s. IESProduce trend analysis reports and sector risk reviews and run sensitivities for concentrations and deviations to expected performance, and recommend strategies to keep the risk within acceptable leve ls.Perform proactive ongoing credit monitoring and risk management at a portfolio level and recommend strategies to keep portfolio risks within stipulated acceptable leve ls.Monitor and report on the performance against the Board approved risk appetite levels and threshol ds.Monitor trends of internal risk grades and produce summary reports that provide insight as to whether rating standards, protocols, and policies are consistently applied across portfolios and secto rs.Recommend stress testing of the book against approved and emerging risk parameters to be conducted by the Quantitative Modeling team and input the results into the analysis of the adequacy of capital and provisions, as well as generating updates on industry risk positio ns.Develop and prepare statistics and report on portfolio trends, and assist the Head of the department and the Chief Risk Officer in preparation to lead the IMC process es.Provide relevant and required information to present to lenders and rating agenci es.Involvement in policy formulation and policy review across a range of key risk management issu es.Development of credit risk systems and procedures, ensuring that these are well managed to support the corporation's business strategi es.Attendance of Investment Monitoring Committees and providing advice on portfolio matte rs.Providing advisory services to Strategic Business Units (SBU's) on Portfolio risk matters and assisting in structuring dea ls.Working with credit risk managers to help ensure that the risks are fully understood by Portfolio Management and are consistent with the firm's client objectives and risk constrain ts.Understanding how macro-economic factors drive the investment decision making proce ss.Supporting the creation, production and delivery of supervisory and marginal reports pertaining to risk management and performance attribut ionMonthly and quarterly reporting to Executive committee and Board Risk & Sustainability Committ ee.Performing ad hoc reporting and analyses to help address real time demands of senior members of the te
Showing 4 Fraud Team Leader jobs in Johannesburg
Sandton, Gauteng R - R Y Bank of China Limited Johannesburg Branch
Posted today
Job Description
Responsibilities
- Candidate will be responsible to support the oversight of key risk areas, namely Operational Risk, Outsourcing Risk, Business Continuity Management, IT Risk, Internal Control, Risk Data Aggregation
- Risk monitoring and control support
- Monitor and provide awareness on tool management
- Collaboration with key stakeholders
- Monitor and enhance internal controls
- Support the organizations business continuity development and implementation
- Enhance the risk data aggregation and risk reporting framework
- Third party risk management
- Update risk management policies and procedure
- Build on the risk culture by coordinating engagements between risk and first line departments and promote a culture of transparency
- Prepare Regulatory presentation
Requirements
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Other locations listed in the original description are included for context but are not part of this refined excerpt.
Head of Oncology Risk Management and Care Coordination
Sandton, Gauteng R - R Y Discovery Ltd.
Posted today
Job Description
Business Unit : Discovery Health
Date : 28 Oct 2025
Discovery Health
Head : Oncology Risk Management and Care Coordination
About Discovery
Discovery's core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.
Key Purpose
We are seeking an experienced and innovative professional to lead the Population Health Management (PHM) strategy across oncology, end-of-life care, and complex multimorbidity. The successful candidate will be responsible for developing and executing strategies for comprehensive, end-to-end solutions for managing oncology risk and the risks associated with members living with complex, high-cost conditions. These solutions must address affordability constraints while improving health outcomes. The role requires a strong blend of leadership, strategic thinking, health system expertise, collaboration, data-driven decision-making, and stakeholder engagement.
Job Responsibilities
The successful applicant will be responsible for but not limited to the following job functions :
Strategic Leadership :
Data and Analytics
Stakeholder Engagement
Contract Management
Implementation and Operational Oversight
Education, Knowledge and Work Experience
Education :
Work Experience :
Knowledge :
EMPLOYMENT EQUITY
The Company's approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.
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Senior Risk Manager : Risk Governance and Portfolio Management(18-months Fixed Term Contract)
Posted today
Job Description
JOB DESCRIPTION
Responsible for Portfolio Management and Reporting within the organisation
QUALIFICATION
JOB EXPERIEN
ROLES AND RESPONSIBILIT
am.
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Team Leader • Johannesburg, Gauteng, South Africa
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