Medical Officer Specialist
3 days ago
Vhi is seeking a highly skilled Medical Officer Specialist to provide medical advice and support to the Claims Department. This role will involve providing clinical guidance, developing guidelines, and conducting research to support the organization's business strategy.
About the Role
This permanent position offers a unique opportunity to work in a hybrid environment, providing flexibility and work-life balance. The successful candidate will be responsible for:
- Providing medical advice to the Claims Department on appeals and Insurance Ombudsman referrals.
- Developing clinical guidelines to support claim assessment.
- Assessing new medical/surgical procedures, technologies, and drugs.
- Reviewing provider utilisation data.
- Participating in clinical billing audits.
- Developing hospital reimbursement systems.
- Conducting research and analysis related to applications for approval of new facilities.
- Working with the Medical and Claims Division to achieve business plan objectives.
Requirements
To be considered for this role, you must possess the following qualifications and skills:
- Full Medical Qualification (MB, BCH or equivalent).
- Current registration with the Medical Council.
- Minimum 7 years post-graduate medical experience – ideally across a range of specialties.
- MICGP, MRCGP, MRCPI or equivalent qualification.
- Medical indemnity insurance.
- Excellent report writing and analytical skills.
Skills and Abilities
The ideal candidate will possess the following skills and abilities:
- Computer literacy – Microsoft Office.
- Compliance with Central Bank's Minimum Competency Code.
- Excellent communication skills.
- Dedication to meeting tight deadlines and achieving objectives.
- Flexibility to ensure the achievement of business plan objectives.
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