Job Openings at KPMG

Key roles and responsibilities

 Leadership and strategy

• Formulate and execute underwriting and enrollment strategies, policies, and guidelines aligned with the company's vision, mission, and values.
• Contribute to the development and execution of the company's strategic and operational plans and engage in cross-functional projects and initiatives.

Risk and compliance management

• Identify, assess, and manage operational risks, ensure robust controls are in place and escalate significant risks to the Risk Management Committee.
• Ensure compliance with risk policies, incident management, privacy, information security requirements, and relevant Kenyan regulations.
• Ensure underwriting and enrollment processes comply with regulatory and ethical standards as well as maintain optimal risk exposure and profitability.

Performance monitoring and quality assurance

• Oversee service quality through rigorous quality assurance measures to ensure compliance with quality and regulatory standards.
• Track and assess underwriting and enrollment performance with key metrics, produce management reports, and take corrective actions as needed.
• Collaboration and stakeholder management
• Build and sustain effective relationships with external customers, partners, and vendors and ensure underwriting and enrollment service standards are met or exceeded.
• Coordinate with other departments in the company and across the wider global operating model for IPMI servicing.
• Manage outsourcing for underwriting and enrollment, ensuring effective service delivery by company entities or third-party providers per service agreements.

Operational resilience and continuous improvement

• Maintain operational resilience and business continuity in the claims process to ensure service continuity and minimize negative customer impact during disruptions.
• Identify and apply continuous improvement opportunities in underwriting and enrollment by leveraging industry best practices and emerging trends.

Technical guidance and support

• Provide technical and operational guidance to the Underwriting and Enrollment team, and support Sales, Marketing, Claims, and Finance on related matters.
• Manage complex underwriting cases and collaborate with sales, governance, and pricing teams for fair resolution.

Academic/Professional qualifications and Experience:

• A bachelor's degree in Business, Medicine, Finance, Actuarial Science or a related field from a reputable and accredited institution of higher learning.
• Professional qualification or certification in underwriting, insurance or risk management is an added advantage.
• A minimum of five (5) years experience in underwriting and enrolment, ideally in international private medical insurance or equivalent such as domestic private medical insurance or life insurance businesses.
• Proven expertise in creating and executing underwriting and enrollment strategies, policies, and procedures while ensuring compliance with regulatory and ethical standards.
• In-depth knowledge of the private medical insurance market in Kenya, including current trends and industry challenges.
• Excellent problem-solving and decision-making abilities, with a strong capacity to analyze service issues and make timely and sound decisions.
• Good communication and interpersonal skills, with the ability to engage effectively with stakeholders at all levels to achieve successful outcomes.

go to method of application »

Key roles and responsibilities

Policy development and implementation

• Develop and implement claims policies, procedures, and standards in line with the company's vision, mission, and values.
• Ensure adherence to the company's enterprise policies, and relevant regulations and legislations in Kenya.

Operations management

• Responsible for claim operations, budget, performance, and customer experience.
• Ensure the timely and accurate processing and payment of claims, delivering a good customer experience while ensuring regulatory compliance.
• Work closely with Head of Group Claims Management to ensure the claims process activities outsourced to service entities or third-party suppliers, are delivered effectively and in accordance with service agreements.

Performance monitoring and reporting

• Monitor and analyze claims data and trends, providing regular management information (MI) and operational performance reports to management committees and the Board.
• Review and update the claims service level agreements and key performance indicators to ensure target achievement and customer satisfaction.
• Oversee the risk and controls in the claims operation, ensuring compliance with enterprise policies, procedures and regulatory requirements.
• Manage service quality through robust quality assurance to ensure adherence to the quality and compliance standards.

Risk management and compliance

• Provide the Board with sound advice, assurance and useful and timely reports from the Audit committee.
• Manage relationships with external stakeholders including Head of Internal Audit and external regulatory bodies, external Audit Partner and auditors.
• Identify, assess, monitor, and manage operational risks associated with the claims handling process with support from the risk management function.
• Collaborate with the claims fraud, waste, and abuse (FWA) function on prevention and detection measures and in driving adherence to anti-fraud policies and regulations.
• Ensure adequate operational resilience and business continuity planning within the claims process to minimize customer impact during disruptions.

Continuous improvement and innovation

• Collaborate with the centralized Claims Process and Payment Integrity function to recommend improvements to local claims policies, procedures, and standards in line with the company's vision, mission, and values.
• Handle complex and escalated claims cases and complaints, ensuring fair and satisfactory resolution.
• Identify and implement best practices and innovations in the claims handling process, enhancing the efficiency and effectiveness of claims systems and processes.
• Drive continuous improvement initiatives within the department to deliver change through innovative solutions, including automation, data analytics, and AI.

Academic/Professional qualifications and Experience:

• A bachelor's degree in Business Administration, Finance, Management, or a related field from an accredited reputable institution.
• A minimum of 5 years of experience in claims management in international private medical insurance (IPMI), or other financial services industries such as domestic private medical insurance or life insurance.
• Experienced claims management and customer service professional.
• Strong ability and proven track record in driving significant claims savings and operational expense cost reductions.
• Proven ability to deliver strong KPI performance in a claim management function through excellent leadership and a strong focus on results.
• Strong problem-solving and decision-making skills with a strong leaning towards innovation and improvement.
• Excellent communication, teamwork and collaboration skills, with the ability to work effectively and cooperatively with others.

go to method of application »

Key roles and responsibilities

Actuarial activities and Board reporting

• Report on technical provisions and liabilities, solvency position, loss ratio performance and key actuarial matters to the Principal Officer, the Board and Executive team.
• Interact with the Global Actuarial function to conduct reserving activity for the company and ensure reserving activity is in line with company’s broader approach to capital and risk management.
• Evaluate and provide advice on key actuarial areas including actuarial and financial risks, investment policies and valuation of assets and current and prospective solvency position.
• Ad-hoc reporting and analysis as required, including deep dives into key focus areas to understand drivers of performance.

Regulatory and statutory reporting

• Support the statutory actuary in completion of company’s regulatory calculations and disclosures, such as financial condition testing and solvency requirements.
• Prepare quarterly actuarial valuation as required by the IRA.
• Liaise with the IRA on actuarial matters, supported by the Principal Officer and the company’s Actuarial function.

Pricing analysis

• Interact with the Global Actuarial Function to coordinate and conduct pricing on new and existing Intelligent
• Platform Management Interface products in Kenya.
• Collaborate with the Global Actuarial Function to facilitate and interpret market inflation and competitor pricing analysis.
• Report on key pricing matters to the Principal Officer, the Board and Executive team.

Tools and framework development and best practice

• Provide actuarial expertise and input in the delivery of the strategic initiatives and apply advanced analytical methods to drive business solutions.
• Identify and support the deployment of new analytical techniques, tools and data sources to streamline the delivery of actuarial activities.
• Promote best practices and continuous improvement processes and procedures.
• Maintain strong relationships with the regulator, financial institutions, auditors and other external stakeholders.

Academic/Professional qualifications and Experience:

• A bachelor’s degree in Actuarial Science, Mathematics, Statistics or a related field from a reputable and accredited institution.
• Pursuing fellowship of the Actuarial Society of Kenya, or equivalent and excelled in recognized actuary professional qualifications.
• Extensive background and proven work experience in actuarial and pricing functions in the insurance or financial services industries.
• Ability to process data quickly, and strong attention to detail.
• Excellent interpersonal, communication and influencing skills and ability to identify business drivers for performance.
• Experience in exceptional stakeholder management and ability to build and strengthen relationships.
• Ability to adapt to changes in business in a fast-paced environment, prioritizing tasks and working through conflicting priorities and deadlines.
• Demonstrate problem solving and decision-making skills.
• Collaborative team player willing to support development of colleagues.