Sr. Manager - IPD Cashless Service Mgt (Health)

About the Role

Responsible for managing IPD Cashless claim operations, ensuring compliance with policies and service level agreements (SLAs). Oversee team performance and development, optimise processes, and coordinate with hospitals and related stakeholders to resolve complex issues while ensuring timely claim payments.

Responsibilities

• Oversee and manage the end-to-end process of IPD cashless claims, ensuring compliance with policy terms and company standards.
• Supervise and guide the team in handling claim approvals, ensuring accuracy, timeliness and adherence to SLAs.
• Plan and allocate tasks; closely monitor team performance to achieve SLA and service quality targets, including real-time monitoring.
• Organise and manage team rosters to ensure full coverage and optimise efficiency of service delivery.
• Develop team skills and knowledge through training and coaching to enhance operational efficiency.
• Monitor and review sample cases for OFR review.
• Coordinate with relevant departments to resolve issues and improve processes.
• Provide guidance and resolve complex claim issues for hospitals and customers.
• Monitor and utilise daily and monthly reports on service volume and turnaround time to manage team performance and ensure SLA targets are met.
• Act as consultant and mentor by advising and coaching both team members and outsourced partners.
• Continuously monitor pending cases and make decisions to clear backlog of IPD cashless cases promptly.
• Ensure timely payment of IPD cashless claims to hospitals in accordance with SLA and contractual agreements.

Qualifications

• Degree in Business Administration, Nursing, Business Sciences (Medical Technology) or related field.
• Minimum 10 years of experience in Health Insurance, Medical or Claims Management.
• Experience in team/people management.
• Data analytical and problem-solving skills.

Nice to Have

• Strong knowledge and experience in cashless claim processes and hospital networks.
• Experience in SLA management and quality control.
• Problem-solving and cross-functional coordination skills.
• Experience in data analysis and process improvement.
• Project management, communication, negotiation and presentation skills.
• Familiarity with AI tools (e.g., ChatGPT, CoPilot365) is an advantage.

About the Company

Allianz Group is one of the most trusted insurance and asset management companies in the world. The company emphasises an inclusive workplace grounded in integrity, fairness and trust, and welcomes applications regardless of ethnicity, age, gender, nationality, religion, disability, sexual orientation or other characteristics protected by local law.