Operations Manager Mozambique

About the role

The Operations Manager will lead the Membership, Claims, Provider Relations and Health Risk Management functions for our Mozambique operations. The role ensures these processes are efficient, user‑friendly and support sustainable growth of the health scheme.

Key responsibilities

• Develop and maintain the largest possible provider network, including public‑sector partners.
• Negotiate preferred pricing with top service providers to keep the scheme claims ratio at 75%.
• Oversee accurate claim processing, prevent stale or fraudulent claims, and report fraud quarterly.
• Enroll members with chronic conditions into appropriate programmes and provide ongoing assistance.
• Ensure flexibility for high‑cost procedures and manage scheme rules.
• Deliver cost‑effective medical assistance while maintaining quality standards.
• Map medication, document and review departmental processes, and conduct regular business reviews.

Required profile

• Relevant business qualification (MBA or postgraduate preferred).
• Extensive experience in financial services and operational management.
• Strong leadership and strategic management capabilities.
• Knowledge of governance, risk, finance and operations.
• Excellent communication, decision‑making and stakeholder management skills.

Required skills

What we offer

• Permanent contract with remote work flexibility.
• Opportunity to shape health and financial services in a growing market.
• Collaborative environment with diverse stakeholders.