Regulatory Complaints

5 days ago

Jeddah, Saudi Arabia Bupa Arabia Full time

Role Purpose:
To manage end to end complaints handling process received from regulators (CCHI and SAMA) by managing daily operation activities, ensuring proper full investigation in alignments with the rule and regulations circulated from CCHI and SAMA, and maintaining agreed service levels. Furthermore, conduct data analysis in order to highlight pain points and act accordingly with stakeholders to enhance customer experience and meet organizational and operational objectives in line with the company's service strategy and values

Key Accountabilities:
1- Manage Complaints Handling Process with Regulators;
- Contribute in executing the organization's service strategy from Regulators Complaints Handing unit prospective
- Establish and maintain a strong and professional relationship with CCHI and SAMA.
- Manage end to end case management of complaints received from CCHI or SAMA within agreed timescales.
- Ensure proper investigation of cases related to internal departments and advise/recommend with the corrective action
- Ensure consistently high level of customer satisfaction
- Conduct quality assurance checked on standards of complaints handling and resolution
- Ensure all policies and procedures related to regulators complaints are followed.
- Manager direct communication with CCHI and SAMA team including their management
- Monitor and manage KPI’s agreed with regulators before regulators publish Bupa’s official results
- Be a point of escalation for all regulators complaints and disputed cases.
- Investigate complaints escalated by Compliance or Legal
- Work under minimum supervision to perform a variety of complicated tasks

2- Service Excellence;
- Manage Quality Agenda for Customer Service in collaboration with TQM and Regulators standards
- Support efficiency workflows for the department with the needed/required tools, solution and technology to reduce manual workload and improve efficiency
- Provide oversight and ensure a seamless change management process to ensure mínimal operational disruption with new communications, implementation and changes received from SAMA and CCHI
- Collaborate with cross functional and external stakeholders to resolve service failures and prevent recurrences

3- Service Delivery;
- Establish proper SLA with internal departments in alignment with SAMA and CCHI agreed KPIs.
- Track internal departments efficiencies and drive improvement initiatives including technology solutions or process improvement
- Build a strong relationship with Cross Functional stakeholders and key leadership
- Provide oversight to ensure the complaints management and recovery process works effectively within the Service Operations framework

4- Project Management;
- Initiate and manage customer service projects/ KAIZEN related to regulators complaints unit to drive transformation and continuous service improvements
- Lead FI’s across Service Operations to improve regulators complaints SLA
- Identify area where processes and system can be improved to increase efficiency
- Explore the possibilities for processes and system automation

5- Analysis and Reporting;
- Collect and analyze regulators complaints statistics by conducting analysis of complaints tried to identify specific repetitive in order to be tackled
- Circulate monthly regulators related analysis reports
- Send quarterly report to the Audit Committee (as SAMA requirement)
- Ad hoc analysis on as needed basis

**Skills**:

- A customer service background in Customer Service, Customer Care, or any Operational Unit
- Multi-cultural with interpersonal and communication skills, excellent planning and execution
- Strong service focused mindset in combination with commercial skills
- Strong presentation and interpersonal skills
- Abel to multitask and work well under stress
- Strong problem-solving and Excellent follow up skills
- Ability to effectively prioritize and execute tasks in a high-pressure environment
- Experience in managing customer service, contact center, call center or customer care management.
- Expertise in the medical field or insurance is a major advantage

**Education**:
Business, Healthcare, or any equivalent

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