Senior Case Manager – Call Centre

About the role

The Senior Case Manager will lead the delivery of high‑quality customer service within a 24‑hour call centre, supporting insured members with their benefit enquiries, pre‑authorisations and complaints. The role combines direct client interaction, technical use of the CRM platform and oversight of call‑centre staffing to ensure seamless, compliant service.

Key responsibilities

• Handle inbound and outbound calls following call‑centre etiquette and stipulated turnaround times.
• Guide members on benefit eligibility, service‑provider selection and claim status.
• Process medical pre‑authorisations, approvals and declines in line with policy provisions.
• Document and resolve customer complaints, escalating unresolved cases when necessary.
• Conduct post‑hospitalisation follow‑up calls and enrol clients in chronic disease management programmes.
• Negotiate rates and recoveries from third‑party payers such as the Social Health Authority.
• Schedule call‑centre staff for 24‑hour coverage, monitor workload distribution and identify service gaps.
• Maintain confidentiality and comply with the Data Protection Act.

Required profile

• Proven experience in a call‑centre or insurance case‑management environment.
• Strong problem‑solving and decision‑making abilities.
• Excellent communication skills and a customer‑focused mindset.
• Ability to manage a team schedule and handle high‑volume enquiries.
• Knowledge of insurance policies, medical authorisation processes and regulatory compliance.

Required skills

• Proficiency with a CRM system.

What we offer

• Opportunity to work with a leading African insurance group.
• Professional development and career growth pathways.
• Dynamic, collaborative work environment.