Assistant Manager - Utilization Management

About the Company

Krungthai-AXA Life Insurance Public Company Limited, created from a solid co-investment partnership between Krungthai Bank PCL. and the AXA Group, global financial protection and asset-management specialists.

The trademark of Krungthai-AXA Life Insurance is designed to indicate the combination of the two corporations. Krung Thai Bank PCL. and AXA Group logos are aligned with Thai characters displaying the company name as Krungthai-AXA Life Insurance placed above the red line and the new company signature. Redefining/Life Insurance.

Today Krungthai-AXA Life Insurance Public Company Limited is a fast-growing life insurance company with a vision – Ambition AXA.

Responsibilities

• Supervise and monitor team daily performing concurrent review of patient clinical information from hospital network to ensure appropriateness of care in accordance with policy terms and conditions.
• Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges, quality of services and cost savings.
• Review and identify errors, missed diagnoses and overutilization issues received from team and develop appropriate action plans to prevent repetitive errors.
• Monitor customer and provider network behavior and escalate issues to stakeholders.
• Perform other duties as assigned.

Qualifications

• Bachelor's degree in Nursing.
• At least 5 years working on ward/ICU in a hospital.
• Minimum 2 years working experience in Life or non-Life Insurance and Health Claims is required.
• Previous training and demonstrated competence in negotiation, quality assurance and case management outcomes.
• Capable to communicate in both writing and speaking English.
• Ability to negotiate and handle issues with external and internal parties.
• Problem solving and decision making skills; able to motivate people to work under limitation and pressure; organize and balance workload.

Benefits

• Employee and Family Health Insurance Benefits.
• Life and Accident Insurance Benefits.
• Hybrid working and flexible working hours.
• Annual leave & birthday leave.
• Salary increment & bonus.
• Digital learning - self learning organization.
• Annual health check up.
• Provident fund.