Head: Affordability & Care Innovation

Discovery Health: Health New Markets

Head: Affordability and Care Innovation

About Discovery

Discovery’s core purpose is to make people healthier and to enhance and protect their lives. We seek out and invest in exceptional individuals who understand and support our core purpose, and whose own values align with those of Discovery. Our fast-paced and dynamic environment enables smart, self-driven people to be their best. As global thought leaders, Discovery is passionate about innovating in order to not only achieve financial success, but to ignite positive and meaningful change within our society.

About Health New Markets

One of Discovery Health’s key strategic objectives is to diversify the business and its earnings by growing non-medical scheme business with a newly established Health New Markets business unit. This objective necessitates leveraging Discovery’s unique IP and shared value model to develop and grow innovative new health products that add value to employers, employees, and individual members beyond Discovery Health’s traditional customer segments.

Discovery’s Health New Market products, include:

Flexicare: Primary healthcare insurance

Emergency Cover: Accident cover

Prepaid: Pay as you go health care vouchers

Gap Cover: Extending medical aid benefits

Healthcare fund: Funds for predefined healthcare expenses

Healthcare Marketplace: An provider and member health services ecosystem

And any other solutions that may be developed in future to add value to employers, their employees, and individual members.

Key Purpose

The Head of Affordability & Care Innovation will make HNM’s products structurally more affordable for consumers while expanding access to care. The role is responsible for mobilising cross-functional teams to drive affordability levers across the HNM portfolio. This includes specific provider model and benefit changes that translate into measurable efficiencies and savings. The role scope further extends to reimagining and designing tailored care and benefit models for new and existing clients which unlock bespoke growth opportunities and push the envelope on how care is delivered. The successful candidate will be responsible for building and nurturing the external provider and ecosystem partnerships that change the underlying cost and reach of care. This role offers a unique opportunity to positively contribute to a growing and dynamic business while gaining exposure to strategic leadership within Discovery Health.

Principal Accountabilities

The successful applicant will be responsible for but not limited to the following job functions:

Product affordability

• Own a defined annual affordability (savings and efficiency) target across HNM products which translate into unlocking greater member value or benefit enhancements (e.g., contribution increases held below market, or richer benefits at constant cost).
• Identify, prioritise and drive specific model, benefit and network interventions that demonstrably lower cost per product
• Convene the HNM Strategic Risk Forum as the mechanism through which savings are identified, modelled, committed and tracked to realisation

Care management and benefit enhancements

• Lead the design of care-management and benefit interventions that lower cost (case management, alternative reimbursement models, network optimisation, and benefit redesign) in partnership with all Strategic Risk Management, Risk Intelligence, Functional Enablement and R&D Lab teams.

Bespoke offerings for large, unique opportunities

• Coordinate the affordability and care-model design for large bespoke employer or group opportunities, specifically owning the cost, benefit and provider-model architecture that makes the opportunity viable.

Provider partnerships

• Network actively across the provider market to stay close to innovative, new and lower-cost healthcare providers whose delivery model, geographic reach or price point advances HNM’s affordability and access goals.
• Identify and pilot ecosystem players uniquely positioned to support HNM products, nurturing promising players from pilot to scale.

Leadership and influence

• Act as the affordability champion for HNM across the business and externally.
• Mobilise and lead cross-functional teams on an ongoing basis to support HNM products from a risk-management and care innovation perspective; leveraging the best of subject-matter experts within Discovery Health

Competencies

The successful candidate will be required to demonstrate the following critical attributes and

competencies:

Cross-functional mobilisation

• Proven ability to mobilise and extract priority from functions that do not report to them, the single most important capability, given HNM’s operating model context.

Analytical & commercial

• Highly analytical mind able to partner Health Actuarial, Risk Intelligence, Business Intelligence and Strategic Risk Management, and to rapidly distil their analysis into a prioritised set of initiatives and insights for the HNM portfolio.
• Strong commercial and modelling judgement with comfort to own the numbers behind affordability and bespoke-opportunity decisions.

Synthesis, communication & partnership

• Excellent synthesis and communication skills that make complex, affordability initiatives simple and tangible for internal and external partners.
• Able to partner stakeholders within and outside of Discovery to “make magic happen” and building trust with providers, partners and ecosystem players.

Innovation orientation

• Keen, current interest in medical and clinical innovation and a genuine drive to shift how care is
• accessed in South Africa.
• Entrepreneurial mindset paired with hands-on execution; comfortable in ambiguous, complex and changing environments.

Discovery leadership fit

• Brilliance paired with values is non-negotiable at Discovery.
• Willingness to say the hard thing in the room, including challenging shared functions on
• prioritisation, balanced with humility.
• Bold goals matched with obsessive excellence in execution.

Education and Experience

• Bachelor’s degree or higher from an accredited university
• Honours or Masters degree (or equivalent NQF Level 8 qualification) in Business Management (Advantageous)
• Substantial relevant work experience (7+ years) across some combination of: healthcare risk/managed care, actuarial or commercial strategy, provider contracting, product development, or management consulting
• Strong experience in leading cross functional teams, strategy development and execution.
• Health industry and Discovery operational knowledge strongly advantageous given the matrixed delivery model

EMPLOYMENT EQUITY   
                             
The Company’s approved Employment Equity Plan and Targets will be considered as part of the recruitment process. As an Equal Opportunities employer, we actively encourage and welcome people with various disabilities to apply.