Pacific Cross Health Insurance PCL - Thailand’s newest yet most experienced health and travel insurance company. Though formed in 2014, our heritage dates back more than 55 years to our establishment in 1957. With our year-long experience and professionalism in the Thai insurance industry, we always strive to excel at what we are doing. We operate in an international corporate environment where staff members are at great opportunities to develop and grow. In response to the growing business, we are currently looking for high performing individuals in the following position to join our team.
jobsDB Ref. JTH300003001256722
Reporting to: Senior medical underwriter/ Consultant doctor
Report directly to the senior medical underwriter/consultant doctor and performs clinical and medical analytic under general supervision in support of underwriting, decision making regarding pricing and selection, eligibility and enrollment and provide clinical analysis critical for decision making towards achievement of business objective using existing policies and guideline.
Duties and Responsibilities:
- Gathers and prepare preliminary clinical and medical analysis based on information from historical claims utilization data.
- Develops/prepare report and assists in the development of new/revised policies and guidelines base on utilization and clinical trends.
- Assists in the administration of assigned program. Develops, maintains, audits and reviews functional database and identifies inconsistencies.
- Prepares clinical and medical recommendations based on data summaries, trend analysis, financial analysis, and business analysis.
- Provide support to rate development through timely and accurate clinical and medical analysis to ascertain future risks and support the underwriting and risk management decision.
- Provide clinical and medical underwriting for the health product.
- Provides clinical and medical underwriting analysis for pricing and risk assessment selections and eligibility including financial, business, and trend analysis of data critical for decision making in achievement of business objective.
- Prepare clinical and medical analysis base on employer group utilization and claims data and coordinates with the appropriate wellness, medical and case management to address these identified risks.
- Assist and provides clinical and medial analysis on actuarial research and studied and product development initiatives.
- Prepare and may do presentations. Participates in cross-functional teams to develop new/enhanced systems/processes/programs/policies to support business needs.
- Performs other duties that may be assigned from time to time.
- Graduated in Bachelor’s degree in Nursing or related medical field.
- Minimum of 1 year experience in performing routine clinical and medial analytical work in healthcare insurance company.
- Effective team player with very good interpersonal relationship skills and can work and relate well with co-employees, patient and customers.
- Must have the behavioral sensitivity, maturity, diplomacy and tact in addressing complex situations.
- Good in communication both spoken and writing – Good in English Communication is essential.
- Strong ethics and a high level of personal and professional integrity.
- Must have basic familiarity on federal and state laws and requirement relating to healthcare management.
- Computer literate and very highly proficient in using MS office program.
Competitive remuneration package will be offered to the successful candidates. Please send your updated resume together with a recent photograph by clicking on "Apply Now"
Human Resource Department, Pacific Cross Health Insurance PCL
152 Chartered Square Building 21Fl. Unit 21-01 North Sathorn Rd. Silom, Bangrak, Bangkok 10500
(We are conveniently located near to BTS Surasak Station)
Tel. 02-4019189 Ext.351
***Only shortlisted candidates will be notified***