Clinical Claims Process Advisor
Core
Improve referral quality, manage clinical demand, and reduce friction in customer journeys by analyzing operational data and developing guidance/referral pathways.
Role type
Clinical Claims Process Advisor (Part-time Secondment)
Builds
Guidance, referral pathways, and knowledge management tools for Health Claims teams.
Domain
Private Medical Insurance / Health Claims
Deliverable
dashboards & analysis
Required skills
Clinical experience in healthcare/PMI, analysis of operational data, risk management, stakeholder management, process improvement
Preferred skills
Experience developing clinical guidance or referral pathways, experience with case management
Technologies
Operational data systems
Responsibilities
Use insight and data to identify opportunities to improve referral quality; manage clinical demand more effectively; support development of guidance and referral pathways; contribute to improvement initiatives for simplification and automation.