Claims Manager

hace 3 semanas


Madrid, Madrid, España The Cigna Group A tiempo completo
The job profile for this position is Claims Manager, which is a Band 4 Management Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

Somos una empresa multinacional de seguros de salud con más de 170 millones de relaciones con clientes y pacientes en más de 30 países y jurisdicciones.

Somos una organización humana, donde las personas son lo primero. Ya se trate de nuestros clientes, asegurado/as o compañero/as, nuestro objetivo es mejorar la salud, el bienestar y la tranquilidad de las personas.

Así, las relaciones sólidas con los clientes son nuestro objetivo principal, y creemos firmemente en la ética empresarial.

Nuestro éxito se lo debemos al talento y la dedicación de nuestro equipo. Ellos son quienes marcan la diferencia en la vida de nuestros clientes. Así que sabemos que es importante hacer un esfuerzo adicional para nuestros empleados. Nos aseguramos de que tengan un buen equilibrio trabajo-vida y ofrecemos numerosas iniciativas para la salud y el bienestar.

Descripción del Puesto

Con reporte directo a la Dirección de Operaciones de la Compañía, el/la Claims Manager gestionará una función clave en la Compañía, dirigiendo un equipo de entre 20-25 personas y responsabilizándose tanto de la gestión diaria de la función de prestaciones como de impulsar la transformación digital y modernización de la misma.

Responsabilidades del Puesto

  • Organizar y supervisar al equipo encargado de la facturación de proveedores médicos, bien sea por medios telemáticos o de facturación no mecanizada. Coordinación de recepción de facturas, establecimiento de controles y control de los niveles de inventarios en cada estadio de facturación, así como supervisión de los trabajos de grabación de los equipos de procesamiento.
  • Gestionar las relaciones externas con proveedores médicos (hospitalarios y profesionales independientes) al nivel de los procesos de facturación, así como de terceros intervinientes en la interoperabilidad de la compañía, fomentando siempre la eficiencia y automatización en los procesos.
  • Mantener y mejorar los KPI's de actividad, incluyendo los niveles de calidad de servicio, control de los inventarios, los plazos de facturación, niveles de automatización y productividad interna, así como contribuyendo a la mejora de los procesos de facturación mecanizada y del auto-pago.
  • Reportar periódicamente los resultados y niveles de actividad, con un enfoque analítico que contribuya a la toma de decisiones inmediatas en el área, así como identificando oportunidades de mejora en el medio y largo plazo de la función.
  • En coordinación con las áreas Financiera y de Gestión Asistencial, gestión de las reconciliaciones y ejecución de deudas pendientes con proveedores médicos.
  • Coordinación con terceros en la gestión de recobros por accidentes.
  • Liderazgo y/o participación en iniciativas internas transversales con otros equipos y/o departamentales en la función, bien sean de carácter local o internacional.

Requisitos

  • Experiencia mínima de 5 años en puesto de perfil similar en el ramo asegurador de Salud, con un profundo entendimiento del impacto de los procesos de facturación en el negocio asegurador y, concretamente, en el ámbito de las reservas financieras.
  • Persona habituada a la gestión equipos de línea de tamaño medio, a la interlocución continúa con proveedores y terceros, y a la participación en iniciativas transversales de compañía.
  • Persona proactiva, resiliente y rigurosa, con claras habilidades de trabajo en equipo, que conjugue bien la gestión diaria de la función con el carácter transformacional requerido en la misma.
  • Orientada a la mejora continua, a la optimización de procesos y a la mejora de la productividad, con conocimiento y uso habitual de herramientas de análisis y reporting (Qlikview o similar), de aplicaciones de back-end asegurador, CRM y paquete Microsoft Office.

Cualificación

  • Cualificación mínima de grado universitario (preferiblemente ADE, Económicas).
  • Se valorará postgrado relacionado con la función o generalista de management (MBA, programa directivo...).
  • Nivel avanzado de inglés.

Ofrecemos

  • Contrato indefinido e interesante proyecto profesional en compañía multinacional.
  • Atractivo paquete de compensación total que incluye salario fijo y variable, así como los siguientes beneficios:
    • Seguro de Salud
    • Ayuda a la comida
    • Plaza de parking
    • Plan de Pensiones
  • Desarrollo profesional, ayudas a la formación y diferentes iniciativas y beneficios relacionados con tu salud y bienestar.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link



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