เงื่อนไขการค้นหา

ประเภทงาน:

งานประจำ

• Review patient admissions and length of stay to ensure medical necessity.
• Conduct concurrent and on-site case reviews.
• Escalate complex cases to physicians when criteria are not met.
• Identify quality issues and flag them to medical leadership.
• Prepare monthly reports and insights for hospital partners.
• Collect only pertinent clinical information and document all UM review information using the appropriate software system.
• Hospital Network Medical AnalysisWork with hospital partners to resolve inappropriate utilization.
• Conduct on-site reviews and service evaluations.
• Investigate and report misuse or abnormal medical practices.
• Medical Services OperationsAppoint and manage panel physicians for pre-insurance checkups.
• Coordinate mobile medical services and scheduling.
• Manage medical room operations (staff, equipment, supplies).
• Support customer medical requests and reports.
• Handle medical document issues with underwriting team.
• Prepare monthly communications (e.g., medical newsletter, updates).
• Support marketing campaigns and customer programs with hospital partners.
• Prepare report and payment for physician fee such as ECG, CxR, Orasure, doctor fee, Bria Lob, PRO lab and medical expense to relevant party every month.
• Coordinate with underwriter by receiving the medical examination documents from underwriter such as incorrect or incomplete to review and provide feedback to physician and nurse, and provide the formal letter to physician and nurse.
• Additional ResponsibilitiesSupport projects (e.g., hospital awards, service improvements).
• Handle customer inquiries and complaints professionally.
• What You Need (Must-Have)Bachelor's degree in nursing science or related field.
• Utilization review / case management / medical cost control.
• Hospital-based nursing (ICU, CCU, or medical ward).
• Strong understanding of clinical decision-making and patient care.
• Experience in claim assessor roles from insurance or healthcare industry.
• Nice to HaveKnowledge of utilization management tools (e.g., InterQual).
• Understanding of medical claims, ICD-10, or insurance practices.
• Familiarity with healthcare analytics tools.
• Good understanding of healthcare regulations.
• Self-driven/management and strongly in result oriented (KPI).
• Collaborative and communication skills.
• Any AI-future skills e.g., ChatGPT, or CoPilot365, will be advantage.
• Why Join UsWork at the intersection of healthcare and insurance.
• Collaborate with leading hospitals and medical professionals.
• Make a real impact on patient care quality and cost management.
• Grow your career in a dynamic healthcare environment.
• Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges is what makes us a unique employer. We are united by a shared commitment: to put our customers first and at the centre of everything we do. Their needs inspire our thinking and guide our actions. Together, we can build an environment where everyone feels empowered and confident to explore, grow and shape a better future - for our customers and for the world around us. At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. The foundation for this is our inclusive workplace, where people and performance both matter, and where integrity, fairness, inclusion and trust are at the heart of our culture. We therefore welcome applications regardless of ethnicity or cultural Internal background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.
• Join us. Let's care for tomorrow.

ทักษะ:

Product Development

ประเภทงาน:

งานประจำ

• Provide professional guidance, medical advice and relevant training to product development, underwriting and claims colleagues.
• Develop and implement AIA's healthcare programmes.
• Work with medical and wellness suppliers to support AIA healthcare programmes.
• May manage rehabilitation cases by assessing claimant's needs, developing rehabilitation plans, and arranging relevant services.
• Responsible for other relating tasks as assigned to align with business policy and build long term business growth.
• Explore opportunity to improve work flow and build healthy environment.
• Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.
• In accordance with recruitment policy and hiring standard of AIA (Thailand) Company Limited, after completing the selection process, you are required for criminal background check before joining the company. Your criminal record information will be retained according to the PDPA policy of the company. As per attached link
• https://www.aia.co.th/th/about-aia/privacy/candidate
• Build a career with us as we help our customers and the community live Healthier, Longer, Better Lives.
• You must provide all requested information, including Personal Data, to be considered for this career opportunity. Failure to provide such information may influence the processing and outcome of your application. You are responsible for ensuring that the information you submit is accurate and up-to-date.

ประเภทงาน:

งานประจำ

• Occupational Health: Fitness to work, Return to work, Medical Surveillance.
• Industrial Hygiene: Health Hazard Management, Health Risk Assessment.
• Fatigue Risk Management, Human Factor and Ergonomic.
• Health Promotion.
• Medical Emergency Response Plan.
• Clinic management.
• Responsible for applying Shell Health protocols and providing expert occupational health guidance to support business operations. Implementing key occupational health and industrial hygiene programs including health risk assessments, exposure monitoring, fatigue risk and human factors.
• Work through Shell Health protocols and processes (such as: Fitness to Work, Health Hazard Management (HHM), Fatigue Risk Management, Human Factor Engineering) to deliver agreed KPIs independently and adapt the protocols to local or individual need.
• Advising key internal stakeholders (employees and lines of business) on occupational health topics and may be the local focal point for specific areas e.g. ergonomics, travel health, and other relevant disciplines.
• Develop and maintain effective medical emergency response plans.
• Provide technical support to site owners to ensure medical equipment and supplies are maintained and ready.
• Collates and escalate issues from the frontline horizontally to asset specialist, and collaborates with central teams to deliver standardized optimised solutions.
• Promote and implement Shell Health activities and programmes to your population (working with key internal stakeholder departments, social/network groups and committees), to improve their physical, mental and social health through care so that they can be at their best.
• Lead, coordinate and collaborate with other businesses or functions, in implementing the physical, mental and social health plans, activities and programmes to the relevant sites and populations.
• Support clinic management and manage medical records relating with medical confidential data of employees.
• Please note: We occasionally amend or withdraw Shell jobs and reserve the right to do so at any time, including prior to the advertised closing date. Before applying, you are advised to read our data protection policy. This policy describes the processing that may be associated with your personal data and informs you that your personal data may be transferred to Shell/Shell Group companies around the world. The Shell Group and its approved recruitment consultants will never ask you for a fee to process or consider your application for a career with Shell. Anyone who demands such a fee is not an authorised Shell representative and you are strongly advised to refuse any such demand. Shell is an Equal Opportunity Employer.