Health & EB Claims Manager
AXA
SPAIN, COMMUNITY OF MADRID, MADRID
hace 2 días

Description

  • Involvement in Sophistication / Improvement of IT systems to improve data availability, automation as well as data quality
  • Provide expertise in innovative new health claims models and vertical integration
  • Contribute to improve and optimize the overall claims management and quality
  • Set up a case management / disease management strategy.
  • Develop assessment tools (i.e. maturity model) and perform on going assessment of entities’ operations and capabilities on claims management (cost containment, medical provider network management and FWA).
  • Set up and monitor action plans within entities to improve quality in claims.
  • Develop and improve quality checking tools, processes and reporting within entities in order to reduce leakage and FWA.
  • Strengthen claims excellence through the introduction of outsourcing and digital capabilities in claims handling where needed.
  • Set up, within the major entities, a case / disease management programme around high-costs claims related to major chronic diseases.
  • Develop and improve customer centricity and customer satisfaction monitoring in claims handling.
  • Provide coaching and guidance, giving feedback to build understanding and sharing information and knowledge around the INM entities with claims management teams.
  • Ensuring successful transfer of processes, tools, methodologies.

    Background :

  • Educated to University degree level.
  • 5-7 years experience in Health Insurance in a local entity (preferably group and individual health)
  • Experience in claims management and quality, customer service.
  • Experience in international projects.
  • Knowledge in insurance procurement, vendor management and IT-platforms
  • Technical skills :

  • Strong project Management skills
  • Excellent knowledge of health claims operations, customer service and technical measures
  • Fluent in English (and ideally Spanish as well)
  • About AXAAs one of the largest global insurers, our purpose is to empower people to live a better life. This purpose is shared by each and every employee throughout our organization, as we tailor our services and solutions to each of our 107 million customers around the world, one person at a time.

    You are the starting point for all our work. We strive to give you more choice, more innovation and more power to decide how, when and where you access our products and services, while making sure we provide excellence, quality and a strong financial foundation for everything we deliver, at the right cost to you.

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