Claims Medical Specialist
Swiss Re, London
About the Role
Are you an allied healthcare professional who’s interested in applying your skills in a business context? We are looking for someone like you to support our Life & Health Claims Clinical Team in London!
As a Claims Medical Specialist, you will review insurance claims cases and provide verbal and written guidance on good practice standards in clinical assessment, treatment, and vocational rehabilitation.
You will seek and apply the research evidence which highlights the benefits of early, collaborative and work-focused intervention using a biopsychosocial approach, to claims assessment and management.
Balancing the risk presented to Swiss Re, you will proactively identify cases for rehabilitation intervention, facilitating service provider referrals, and monitoring intervention to optimise claims management outcomes.
Core to your role will be championing the team’s passion to promote evidence-based early intervention and holistic health management, in an insurance context.
Furthermore your tasks will involve:
- analysing the efficacy of rehabilitation interventions on claims portfolios, using quantitative and qualitative insights, identifying trends, risks and opportunities.
- maintaining knowledge of clinical and rehabilitation developments; identifying when these may be a risk or opportunity for Swiss Re, and communicating this to colleagues along with recommendations for management strategies.
- attending networking and professional development events to ensure awareness of developments within the rehabilitation industry, locally and globally.
- building and managing relationships with clients and with rehabilitation service providers.
- producing and delivering training and thought leadership material on good practice standards in return to work, rehabilitation and clinical assessment.
- collaborating optimally with colleagues including claims teams, medical advisers, legal counsel, as well as underwriting, pricing, portfolio management and sales colleagues, helping to define and deliver high quality services to our clients.
- recording and maintaining accurate claims data on Swiss Re systems as required. About the Team
About the Team
As a small healthcare professional team within the insurance sector, the Clinical team works closely alongside the wider Claims team to assist our clients in supporting their customers back to work and better health, by bringing innovation and evidence-based good practice from the clinical, rehabilitation and work and health fields, into good claims management practice.
You will report directly to the Life & Health Claims Medical Manager who is responsible for clinical/rehabilitation initiatives and innovation in the UK and Ireland (with insights shared across the EMEA region and globally).
About You
You will have:
- a Graduate-level education in a relevant medical / allied health field (e.g., occupational therapy, physiotherapy, psychology, mental health nursing, etc.)
- excellent medical, occupational, and technical knowledge relevant to clinical condition management of common health conditions
- experience in providing clinical rehabilitation; specialisation in the area of vocational rehabilitation is highly desirable
- experience in identifying customer training needs, and delivering engaging and impactful training content
- excellent interpersonal skills including diplomacy and influencing skills
- strong written and verbal communication skills
- an agile, solution-orientated and commercial approach
- strong analytical thinking
- attending networking and professional development events to ensure awareness of developments within the rehabilitation industry, locally and globally.
- experience in working with rehabilitation service providers within an insurance or occupational health setting (desirable)
- experience in managing projects and specifically clinical and/or rehabilitation service development, implementation and evaluation (desirable)
- a basic understanding of relevant UK insurance practice and regulatory issues and initiatives which impact on bottom-line results (desirable)
IT skills:
- proficiency using Microsoft suite, especially Excel, PowerPoint and PowerBI at a basic / intermediate level
- experience in quantitative / qualitative data analysis and ability to identify trends in data
- familiarity with basic statistical principles About Swiss Re
About Swiss Re
Swiss Re is one of the world’s leading providers of reinsurance, insurance and other forms of insurance-based risk transfer, working to make the world more resilient. We anticipate and manage a wide variety of risks, from natural catastrophes and climate change to cybercrime. We cover both Property & Casualty and Life & Health. Combining experience with creative thinking and pioneering expertise, we create new opportunities and solutions for our clients. This is possible thanks to the collaboration of more than 14,000 employees across the world.
Our success depends on our ability to build an inclusive culture encouraging fresh perspectives and innovative thinking. We embrace a workplace where everyone has equal opportunities to thrive and develop professionally regardless of their age, gender, race, ethnicity, gender identity and/or expression, sexual orientation, physical or mental ability, skills, thought or other characteristics. In our inclusive and flexible environment everyone can bring their authentic selves to work.
Interested? – apply here!