Head of Medical Management

This role will be responsible for: 

• Managing complex medical claims and utilization review processes while ensuring optimal patient care.
• Handling difficult and high-stakes medical hotline cases requiring immediate, expert decision-making.
• Heading, Optimizing & Managing TPA relationship & Network
• Providing TGovernance, thought leadership and training for CFR, concurrent review, and Credentialing of assesses

Requirement: 

• At least 15 years of experience in healthcare management, particularly in medical claims, utilization review, or provider network management
• Experience in leading a medical team or department, preferably in a healthcare insurance or managed care setting
• Proven ability to present and communicate medical and clinical information to non-medical stakeholders.
• English Proficiency (Written and Verbal): Excellent command of the English language for professional communication, both written and spoken
• Presentation Skills: Strong ability to present complex medical and utilization review concepts to diverse audiences, including internal teams and stakeholders
• Able to utilize GenAI or AI to support daily tasks

[please translate into your local language]

98348 | Physicians | Professional | Non-Executive | Allianz Indonesia | Full-Time | Permanent

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 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.