Role Purpose

The Manager Wellness will lead the development, execution, and management of corporate wellness programs. The role holder will focus on driving strategic initiatives that enhance customer and employee well-being, integrating wellness solutions into insurance products, and fostering a culture of preventive healthcare. He/she will also ensure alignment with regulatory requirements and corporate objectives while positioning the company as a leader in health and wellness solutions. The Wellness Manager will be responsible for implementing and improving Value Based Care, promoting sustainable healthcare delivery through preventive, promotive, and protective strategies. The role also includes overseeing population health initiatives, technology deployment, clinical integration and strategic planning to enhance health outcomes, improve the quality of care, and optimize Total Medical Expense Management.

Main Responsibilities
Strategy

• Develop, implement and supervise Wellness Programs using evidence-based guidelines to add value, drive clinical performance, improve retention and reduce disparity.
• Structure, Implement and supervise disease management programs and care coordination through the continuum of care.
• Structure, Implement and supervise performance of new products and packages that promote preventive health services.
• Collaborate with members of the Leadership team on the development of the annual Wellness strategic goals and objectives.
• Spearhead development and successful rollout of preventive health technologies.

Operational

• Serve as one of the organization’s key spokespersons on value-based care, educating clients, employees, clinicians, and other stakeholders on the expected changes in healthcare.
• Work closely with care management and provider partnerships to foster provider alignment with the clinical strategic priorities of the organization and needs of Jubilee Health clients.
• Implement and evaluate population health strategies that address the utilization, quality, average cost of care, patient satisfaction, and overall marketplace competitiveness.
• Work closely with the Head of Clinical Operations to Identify Key Market drivers and develop plans and strategies to address incident rates and claim costs.
• Work closely with the Head of Clinical Operations to ensure providers adhere to best clinical practices, cost of care standards, and where necessary, address inappropriate or poor performance.
• Monitor disease-specific and cost of care metrics to ensure the delivery of value-based care within quality standards.
• Work closely with the Head of Clinical Operations to review, align and implement quality metrics related to patient care.
• Monitor performance indicators, patient and provider satisfaction and implemented changes to improve customer retention and net promoter scores.
• Conduct real time analysis of disease trends based on clams’ data and advise the clinical operations team on appropriate interventions.
• Provide medical expertise and leadership in the development and implementation of clinical disease and population health management strategies.
• Work closely with the Head of Clinical Operations to develop and implement medical management initiatives and provide leadership in implementation and interpretation of clinical review policies and guidelines, evidencebased guidelines, and pharmacy benefits management to achieve set performance standards and targeted benchmarks.
• Implement and supervise prospective, concurrent, and retrospective reviews of medical services provided to covered lives.

Leadership & Culture

• Guide and support health navigators in their communication and collaboration with providers to establish clinical programs improve the quality and efficiency of care while providing value to all stakeholders.
• Supervise third party providers contracted for Chronic Disease and Population Health Management.
• Supervise third party providers offering Telehealth Services.

Corporate Governance

• Stay informed about and strictly adhering to all external laws, including Anti-Money Laundering (AML) and Counter Financing of Terrorism (CFT) laws, Data Protection laws, and any other relevant regulations applicable to the industry as required by IRA, CMA, RBA and any other regulator.
• Understand, implement, and enforce internal company policies, processes, and procedures; Ensure that operational compliance programs are in place within your department.
• Develop and implement processes and controls that promote compliance with external laws, regulations, and internal policies.
• Foster a robust ethical culture within the organization, Lead by example, demonstrating and promoting ethical behavior, integrity, and compliance with laws and regulations.
• Encourage open communication and reporting of any potential compliance concerns or violations.

Key skills and Competencies

• Healthcare Knowledge; A strong understanding of the healthcare system, including insurance plans, medical terminology, and healthcare policies and regulations.
• Communication Skills: Excellent verbal and written communication skills to effectively interact with clients, healthcare providers, and colleagues.
• Empathy and Compassion; The ability to empathize with clients’ health concerns and provide compassionate support during difficult times.
• Active Listening: The skill to actively listen to clients, understand their needs, and address their concerns effectively.
• Problem-Solving Skills: Strong problem-solving abilities to help clients overcome barriers to care and find solutions to complex healthcare challenges.
• Strategic Thinking – Ability to align wellness programs with business objectives.
• Innovation & Problem-Solving – Creativity in developing new wellness solutions.

Academic and Professional Qualifications

• Bachelor of Science in Clinical Medicine & Surgery.
• A master’s degree in healthcare management/public health is an added advantage.

Relevant Experience

• At least 5+ years of experience in wellness program management, health promotion, or corporate wellness within insurance, healthcare, or a related industry with strong knowledge of preventive healthcare, employee wellness, and behavioral health strategies and experience in developing and implementing wellness programs with measurable outcomes.