Job ref no.: CT3117255-01#3992

Claims, Manager, Medical Excellence, GI

Peoplus Recruitment

About the role

  • Being part of the team, you will apply your professional knowledge and expertise to act as a technical resource to Claims by monitoring the claimants’ medical treatment for moderate and complex injuries to ensure quality, effective and cost- effective manner in bodily injury claim handling.
    • Strategizes with claim handlers to assess and manage medical and disability exposure and return to work options, and advise on case management plan
    • Assist and provide guidance to claims handlers on formulating case strategy, setting up of case reserve for bodily injury cases, assessment and case management plan and follow up communication, closure and billing
    • Assist and provide guidance to claims handlers to resolve medical related technical issues
    • Collaborate with Vendor Management on rehabilitative services, panel selection and evaluation to ensure services are consistent with the injury
    • Coach and upskill claims handlers on medical case management
    • Manage key internal and external stakeholder relationships across the organization in order to ensure effective communications and transparency
    • Drive and implement medical case management initiatives, conduct files review on bodily injury case
    • Model behaviors that demonstrate commitment to corporate values and updated development and major decisions of the industry

What we're looking for
  • University degree in Medicine, Physiotherapy, Occupational therapy with 5 years or more Medical Case Management experience
  • Registered doctor, physiotherapist or Occupational therapist
  • Clinical experience in orthopedics, Accident & Emergency, Occupational medicine
  • Expert handling knowledge in Employees’ Compensation healthcare management and able to understand the claims market agreements and how to get access to the specific knowledge
  • Knowledge of the medical industry and services, legal systems and interpretation of legal liability
  • Knowledge of identifying and engaging with lead experts with excellent negotiation skills
  • High level awareness of interdependencies with other Zurich Functions (Finance, Reinsurance, Marketing, Actuarial, Underwriting and Legal)
  • Recognise relevance of customer proposition, how to interpret specific handling requirements and benefit of providing excellent customer service
  • Desire to learn and be flexible to business change
Action now
  • Interested parties please send full resume with Current and Expected salary by clicking Apply Now
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More job information
Job ref no. CT3117255-01#3992
Salary
  • N/A
Job Function
Industry
Employment Term
  • Permanent
  • Full-time
Experience
  • 5 years - 10 years
Career Level
  • Middle management level
Education
  • Degree