Medical & Partner Management Officer (m/f/d)

Munsbach, Luxemburg – In this position, your key responsibilities will be to conduct Medical Underwriting within the scope of new insurance business assessment by applying medical expertise and following acceptance processes. As a proactive member of the Medical team, you will support cost containment strategies and medical management of cases.

Additional goal as a member of partner management team, you will support to develop, manage and steer the relationship with Globality Health’ s service / cooperation partners and secure consistency and adherence to agreed performance targets, including the conduct of business reviews and payment oversight.

About Globality Health

Globality S.A. is an international health insurer and the center of competence for the expatriate healthcare business of the Munich Re Group. With more than 65 million expatriates living and working world-wide, Globality operates in a rapidly growing, highly dynamic market. Internationally operating companies and their expatriate staff as well as individuals and their families place their trust in Globality’s expertise. The company launched its operations in April 2008. With headquarters based in Munsbach, Luxembourg and its world spanning network of assistance and service partners, Globality’s reach is truly global.

Your Responsibilities

Medical Underwriting

Evaluate medical risks for new individual and group businesses in line with underwriting guidelines and align with internal stakeholders
Analyze medical reports
Develop and maintain the medical underwriting guidelines/processes for both individual and group businesses
Complement the product development process by providing medical expertise
Provide internal trainings about medical underwriting
Decide on Pre-existing checks for facultative contracts/cases from existing policies and communicate appropriate consequences
Support in planning and implementation of MUW tool

Medical Management

Checking on medical necessity of the treatments of claims
Checking pre-existing conditions
Evaluating medical condition and treatments against benefit coverage
Advising on reasonability of costs, including guarantee of payments and steering of client for cost optimization
Examining potential medical frauds
Preventing unnecessary treatment and over utilization of services by medical providers and clients
Conduct medical trainings
Create, maintain and publish internal medical guides, training materials to relevant teams as and when needed
Provide support on Emergency Assistance cases and feedback management when necessary

Partner Management

Develop and manage relationship with the allocated service/co-operation partners and secure consistency and adherence to agreed targets, including performance reviews
Management of partners in the activities of initiation, maintenance and co-ordination on different aspects of partnerships like contractual, operational, commercial and strategic levels
Negotiate, draft and document new service partner contracts and conditions as well as renewal conditions

Your Profile

Medical background (e. g. as Doctor or Nurse) or economic / insurance background with medical experience

Strong ability to effectively assess medical conditions and the associated risks

Ability to think and work in an multicultural international environment

Thorough and decisive work attitude with excellent analytical skills

Excellent verbal and written communication skills in English. Ideally additional language skills (German, Spanish, French)

Experience in partner, TPA & network management at an insurance company would be ideal

Strong MS Office and data analysis skills

Apply now!

If you would be a great fit for the Globality Health team, send us your CV and cover letter via: recruitment@globality-health.com