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Medical Relations Manager - Health


  • Cork
  • Not disclosed
  • Permanent full-time
  • Updated 21/12/2012
  • Ciara Stewart
this job is expired


Job Title: Medical Relations Manager Aviva Role Level: D Reports to: Senior Health Claims Manager Company: Aviva Health Insurance Ireland Limited Location: Aviva Of


Job Title: Medical Relations Manager
Aviva Role Level: D
Reports to: Senior Health Claims Manager
Company: Aviva Health Insurance Ireland Limited
Location: Aviva Office, Airport Business Park, Cork
Duration: Permanent

This role has been determined as a CF5, CF6 and CF7 under the Fitness and Probity Regime


Aviva Health is Ireland’s fastest growing provider of private health insurance and we are now seeking an ambitious and driven Medical Relations Manager to join our Claims Department and take responsibility for enhancing our capabilities and ensuring the effectiveness of our claims function. This is an ideal opportunity to move into an exciting and challenging role and to enhance your skills and develop your career within a very successful and ambitious company.

The successful candidate will have a minimum RGN qualification and a background in health insurance or life insurance an advantage.

Duties & Responsibilities

  • Review high value/complex claims to ensure claims are paid in accordance with assessment rules and policy terms and conditions
  • Coordinate and Manager the  Recovery division of the Aviva Claims Department to identify and investigate and pursue opportunities for Claims Recovery
  • Investigate anomalies identified through Claims Data Analysis and pursue recovery where appropriate
  • Perform hospital length of stay reviews to determine reasonable and necessary care and appropriateness of stay
  • Support the claims department’s efforts to achieve cost containment and achievement of the targeted loss ratio
  • Providing leadership, direction & motivation for staff in area
  • Ensure that all existing operating service standards are consistently met and devise strategies to improve these further
  • Develop and maintain good working relationships with all departments and support them according to their needs
Skills / Competencies / Experience/Qualifications

  • RGN qualification or similar qualification essential
  • Health insurance or Life Insurance claims experience is desirable
  • One of the following professional qualifications is desirable –PMI Dip, ACII, CIP or QFA with a bridge to GI
  • Strong relationship management skills
  • Experienced in developing and enhancing core business processes
  • Excellent verbal & written communication skills
  • An ability to work enthusiastically on own initiative and as part of a team to agreed deadlines
  • Ability to get work done through a dedicated team of people
  • Ability to establish & maintain effective relationships with all stakeholders, internal & external
  • Excellent interpersonal & communication skills
  • Attention to detail and ability to drive initiatives to successful conclusion
  • Ability to work as part of a dynamic company with a focus on innovation, results, and a commitment to excellence is essential
  • The selected candidate will understand the value his/her contribution can add to a successful business and will have an evidenced based track record in delivering sustained results, which positively impacted his/her company
  • The individual selected will be motivated to make a difference and play a very significant part in the delivery of our business objectives.
Shortlisting will apply.

Ref: 805657
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