Associate Medical Officer appointment – VHI Insurance
Associate Medical Officer
Vhi Healthcare is Ireland’s leading private health insurer. We’re dedicated to providing world-class healthcare solutions for our one million customers, ensuring they get the very best. Our healthcare expertise is unrivalled, with over five decades of experience in the Irish health insurance market. We’re constantly developing new and innovative services to meet the ever-changing medical needs of our customers that deliver on our promise.
The Associate Medical Officer shall be responsible for the provision of a professional medical resource to support the organisation’s business strategy particularly in the area of claims cost management.
The Associate Medical Officer will report to the Head of Medical Relations and will be an integral part of the Medical Relations team and the wider Medical Division. Key responsibilities but not limited to:- • Provision of medical advice to the Medical Division. • Development of clinical guidelines to support the assessment of claims. • Assessment of newly emerging / emergent technologies. • Development of quality outcome metrics to support contracting with providers and to support, drive and develop the organisational objectives around BHO (Better Health Outcomes). • Review of provider utilisation data. • Participate in clinical audits. • Participate in the development of hospital reimbursement systems. • Conduct research and analysis related to applications for approval of new facilities. • Work as part of a team to support
the achievement of the Medical and Claims Division business plan. • Maintain ongoing CME and stay up-to-date with latest evidence based clinical practice and guidelines. • Provision of medical advice to other departments within the organisation as required.
Key Performance Indicators• Ensure claims referred for medical advice comply with best medical practice and Vhi’s Rules – Terms and Conditions of Membership. • Working productively and fulfill all agreed SLAs relating to claims processing. • Develop clinical guidelines and assessments of new treatments within agreed timelines. • Completion of clinical audits against the clinical audit plan. • Comprehensive investigation of utilisation data as required. • Keep abreast of developments in medical care and conduct research and analysis relevant to the role. • Excellent verbal and written communication skills.
Required Skills and Competencies• Full Medical Qualification (MB, BCH or equivalent). • Current registration with the Medical Council. • Minimum seven years post-graduate medical experience – ideally across a range of specialties. • MICGP, MRCGP, MRCPI or equivalent qualification. • Medical indemnity insurance. • Computer literate – familiar with Microsoft Office. • Compliance with Central Bank’s Minimum Competency Code.
• Dedication to meeting tight deadlines, achieving objectives on a consistent basis and demonstrating flexibility to ensure the achievement of these.
VHI is an equal opportunities employer.
Applications should be submitted to https://www.vhi.ie/about/recruitment by the close of business on Wednesday 21st December 2016.