Lead, Claims Risk Management Consultant

AIA Hong Kong and Macau; Singapore; On-site; SGD 100,000 - 120,000; Full time

Job summary

A leading health insurtech company in Singapore seeks a Lead, Claims Risk Management Consultant. The role involves serving as a key advisor to clients in the healthcare sector, focusing on claims risk management while developing training materials. Ideal candidates will have over 10 years of experience in healthcare and a deep understanding of health insurance practices. A collaborative and innovative environment awaits those looking to make a significant impact in the industry.

Qualifications

• 10+ years of experience in healthcare with 5+ years in health insurance risk management.
• Proficient in clinical terminology and population health concepts.
• Experience designing healthcare initiatives for payers.

Responsibilities

• Serve as a trusted advisor to clients on claims risk management.
• Engage with clients to identify strategic healthcare needs.
• Develop training material and deliver client workshops.

Skills

Healthcare domain experience

Health insurance knowledge

Claims risk management

Health data analytics

Education

Bachelor or master's degree in healthcare or related field

Job description

Lead, Claims Risk Management Consultant page is loaded

Lead, Claims Risk Management Consultant

Apply locations Singapore, SG-Amplify Health time type Full time posted on Posted 30+ Days Ago job requisition id JR-46229

Do meaningful work with us. Every day.

At Amplify Health, we’re looking for individuals with ambition, resilience and passion for healthcare, insurance, wellness and digital technology. As a fast-growing business with the ambition of making people and communities across Asia healthier, we have exciting career opportunities available to help us achieve our vision.

Our Culture and Values

At Amplify Health, we believe in fostering a culture that embodies the spirit of Courageous Entrepreneurs. We are passionate and innovative individuals who continuously strive to push boundaries and think outside the box. We understand that calculated risks are essential for driving progress, and we view failures as valuable opportunities to learn and grow.

As Outstanding People, collaboration, learning, and growth are at the core of our values. We trust and rely on each other, working together as a unified team to achieve our goals. When success comes our way, we celebrate it as a collective achievement, and we are committed to improving and excelling together.

We firmly believe in the mantra of Discuss, Decide, Do. Listening is fundamental in our decision-making process, and we act promptly, ensuring accountability in everything we do. Simplicity is the key to our efficiency, and we get things done quickly and effectively while being guided by facts and understanding.

At the heart of our pursuits lies a Lasting Impact. We prioritize the needs of our customers, and we are crystal clear about the problems we are solving for them. Progress is our north star, and while we strive for excellence, we acknowledge that perfection is a journey, and we remain focused on delivering excellent products that make a tangible difference.

If you are a passionate and innovative individual who thrives in a collaborative environment, where courage is celebrated, and customer focus is paramount, we invite you to join our team. Together, we will shape the future with our unwavering commitment to excellence and the determination to make a lasting impact in the industry.

What you will do

You will work in a coaching and consulting capacity as a subject matter expert (SMEs) linked through one or more of the Amplify product offerings that relate to better managing claims risk or healthcare funds. You will prep training material for client teams working in claims, provider management and plan design, amongst others. You will problem solve, guide, design, and stress test potential solutions and initiatives, some of which may link to Amplify products, whilst others may be bespoke.

As a Lead Risk Management Consultant you are required to actively support the in-country client engagement team in understanding the client’s ambitions, needs and gaps as they relate to your area of expertise, as well as work more broadly across the region in raising awareness around Amplify’s expert team capabilities.

How you would make a difference

Your primary responsibilities include:

• Serve as the strategic partner and trusted advisor to clients (private insurers or government healthcare funders) in the management of their business towards seeking higher value healthcare funding
• Engage through structured discussions with clients to identify their strategic needs and priorities and develop potential solutions to inflationary healthcare costs
• Request and oversee qualitative and quantitative analyses to be undertaken in the identification and understanding of client challenges and the development of client specific solutions
• Provide strategic consultative advice to client teams around the design, delivery and ongoing management of claims risk management programs or initiatives
• Contribute to the development of innovative client solutions including new insurance plan design, provider management, operational claims process improvement, and patient care pathways.
• Create value for our clients with forward-thinking and practical solutions that help them address theoperational, technical, and financial implications of changes in their business environment.
• Partner closely with in-country Amplify client leads (where relevant) to bring your expertise in driving healthcare funding towards better value
• Stay ahead of relevant market trends, latest case studies, and global developments which can serve client discussions and ideas
• Work with the central head of professional services to develop and enrich training material for upskilling client workshops based on identified client capability needs
• Deliver client training with senior support across various Asia markets

What you need to be successful

Qualification, Skills and Experience:

• Bachelor or master’s degree (e.g., healthcare, wellness, business, economics)
• 10+ years of working experience in healthcare domain with 5+ years of health insurance or public health funder strategic risk management experience in topics such as funding models, value based care, claims cost containment, and provider performance based contracting.
• Clinical background ideal but open to other backgrounds so long as have proficiency in clinical terminology and clinical work, deep understanding of population health concepts, medical procedures, patient journeys, etc.
• High confidence and proficiency in health data analytics concepts such as risk adjustment, case mix indices, digital twins for comparison of outcomes, etc.
• Real world experience of designing and implementing initiatives that relate to managing healthcare provider value, claims spend efficiency and patient journeys on behalf of private or public payors including provider contracting, alternative reimbursement models, network creation, and setting of care shifts. Ability to speak to case examples of these is key.
• Credibility and experience as an expert in value driven funding a must, given need to work with multiple market teams in front of exec level clients.
• Ability to coach, train, and support in-country teams to serve clients looking to upskill their teams and to operationalize data driven insights.

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.

ABOUT AMPLIFY HEALTH

Amplify Health is a leading health insurtech businessthat offers integrated,digital health technology and data analyticssolutions to payors, insurers, employers, and providers. We partner with all participants in the healthcare system to transform healthcare delivery and insurance. The result is a better healthcare systemand a healthier societyforall.

We have a bold vision: to make Asia healthier by creating and sharing value in health systems through best-in-class technology, data science and talent.

Healthcare is one of the fastest-changing industries today. Globally, new heath digital technology is creating opportunities to positively shape the lives of people and communities. If you’re passionate about digital tech, health and changing healthcare for the better, join us and do meaningful work, every day.