Qureos Mentor

Nextcare

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 Job Overview
 
 
 
 The Data Intelligence Reporting Specialist will be responsible for data mining, design of, creation and timely production of accurate International Health reports. Maintenance and support of these reports within the global reporting team for Health OEs: Allianz Care, Nextcare, Medi-24, Mawista and Australia Students as well as across all departments within Operations is also required.
 
 
 
 What You Do
 
 
 
 Responsibilities will include, but are not limited to, the following:
 
 
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 Train and mentor team members on data analysis tools and techniques, such as SQL, Excel, PowerBI, Alteryx, and Celonis.
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 Lead data-driven projects and initiatives to improve operational efficiency and effectiveness.
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 Actively participate in strategic planning sessions to provide data-driven recommendations and insights.
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 Monitor and track key performance indicators (KPIs) to assess business performance and identify areas for improvement.
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 Supervise and coach the data team, providing guidance on technical skills and professional development.
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 Ownership of Dashboard creation on top of reporting for all 5 Allianz Partners Entities.
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 Creation and maintenance of reports and data in line with documented Key Performance Indicators (KPIs).
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 Ability to design, create, maintain, enhance, and analyze dashboard reports and KPIs across a number of data intelligence tools.
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 Understand the data relationships that exist between the business processes and systems. In turn apply this knowledge when interpreting the information requirements from the business.
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 Ability to identify changing trends and anomalies in data and investigate/ explain same.
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 Ability to translate data, analysis, and commentary into a clear and concise story to support management in strategic decisions.
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 Creation, test, and delivery of existing and ad-hoc reporting from current systems
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 Maintenance of reporting from legacy systems including highly complex reports e.g. Claims trend &amp; Leakage reports to agreed deadlines.
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 Ability to gather, interpret, identify gaps, and translate business reporting requirements into global reporting solutions.
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 Creation of ad hoc data extracts from an oracle database via SQL.
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 Understanding database concepts and terminology, database design principles and elements to deliver reporting.
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 Expert knowledge of the functionality available within PowerBI, Oracle Database, Alteryx, Celonis and Excel.
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 Creation and maintenance of robust testing, analysis, and aggregation of formatted data to ensure data trustworthiness.
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 Enhance Data Quality and Integrity within Allianz Partners systems.
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 Proactively manage and own daily, weekly, and monthly workflow to ensure key performance indicators and service standards are met.
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 Continue to develop technical and systems knowledge, business and insurance understanding and support other team members.
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 Act as the Operations reference point for all Business Information Management related questions.
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 Ensure all Operations data performance is aligned with key stakeholder data e.g. regional office alignment.
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 AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.
 
 
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 At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.
 
 
 
 What You Bring
 
 
 
 To be successful in this position you will need to have the following skills/ experience:
 
 
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 Minimum of 5 years&rsquo; experience with extensive knowledge of Management Information Systems (preferably within the insurance/financial services industry).
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 Exceptional analytical skills (capable of understanding complex data structures, organize and structure data extract and transformation processes).
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 Excellent presentation skills, Customer focused, confident, personable character.
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 Personal Effectiveness &ndash; highly motivated, proactive, self-starter, responsible and highly committed, high attention to detail and accuracy.
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 Experience in working to and meeting deadlines.
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 Role model who inspires and motivates others to perform, effective team player.
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 Proven Management Information reporting experience and Business Analyst skills including: Requirement&rsquo;s analysis / ability to interpret users&rsquo; needs.
 
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 Source data analysis and consolidation.
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 Report building and writing.
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 Financial &amp; KPI reporting
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 Data modeling as an integrated model in a common landscape
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 Data Quality and Integrity
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 Problem solving &amp; effective solution delivery.
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 Demonstrable expert knowledge of the following tools: PowerBI, SQL, PLSQL, MS Excel, MS Access
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 Additional experience with the following advantageous: VBA, Oracle
 
 
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 How We Hire
 
 
 
 
 
 Agency Statement
 
 
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered.
 
 
 
 
 What We Offer
 
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.
 
 
 95688 | Operations | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
 
 
 Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and 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. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
 
 
 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.
 
 
 
 Great to have you on board.
 
 Let's care for tomorrow.
 
 
 Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz&lsquo; company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.
</div>

Data Intelligence and Reporting

<div>
 
 Job Details
 
 
 
 Allianz Care provides insurance solutions for health, life and disability on a global scale. Our focus is on earning and maintaining client loyalty by providing a global, market leading, level of service and support. We are the international health division of Allianz Partners and part of the Allianz Group.
 
 
 
 Medical Services Division
 
 
 
 Multinational corporations with employees working in remote environments, for example within the mining, construction or oil and gas or for IGO`s who often face challenging conditions when medical assistance is needed. At Allianz Care, we provide medical assistance globally and have growing needs due to recent client wins.
 
 
 
 What You Do
 
 
 
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 Preauthorization of in-patient treatment.
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 Aggressive cost containment through tight adjudication, correct evaluation of medical appropriateness and successful negotiation.
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 Case management of complex high value cases.
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 Maintain relationships with brokers/clients/providers.
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 Medical claims reviews.
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 Responsibility for Health, Safety and Welfare within team (please refer to the Company`s Safety Statement for full list of responsibilities).
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 Adapt AI technologies to support various ad hoc duties as needed, enhancing overall operational efficiency.
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 Employ conversational AI tools to enhance communication and maintain relationships with brokers, clients, and providers. AI can provide insights for personalized engagement strategies, improving client satisfaction.
 
 
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 What You Bring
 
 
 
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 Medical / Pharmaceutical qualification.
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 Previous clinical experience.
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 Flunecy in English is a must.
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 Fluency in a second European langugae is a must (French or German)
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 Experience within in the insurance industry, ideally in healthcare is a plus.
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 Negotiation experience.
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 Strong Knowledge of Microsoft Office (Excel, Word).
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 Candidates need to be eligible to work in Egypt without any restrictions.
 
 
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 </ul>
 At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.
 
 
 
 What We Offer
 
 
 
 Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.
 
 
 Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
 
 
 We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
 
 
 We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulators.
 
 
 Join us.
 
 Let's care for tomorrow.
 
</div>

Medical Advisor - French

<div>
 Medical Officer &ndash; Inpatient Precertification is responsible for managing the Inpatient Precertification cases while ensuring that departmental goals, timeline of activities, and compliance measures are met.
 
 
 
 What You Do
 
 
 
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 Precertification team is functional on 24/7 basis. Therefore the Medical Officer will be working on flexible shift basis as per the schedule provided by the Team Leader.
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 Adjudicates Cases at IP precertification level, authorizes decision within the stipulated turnaround time &amp; with the highest quality standards in view with the policy terms and conditions.
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 Performing complete file review with regards to the multidisciplinary notes, TPR charts, physician order&rsquo;s notes, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, progress notes, etc.
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 Requesting any medical documentation or finding any missing document which is essential in decision making.
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 Performing review of DRG Severity of Illness (SOI) in line with revision of CPT codes / ICD codes, which are being up-coded by the provider &ndash; if required discussion with the treating doctor and the medical coders.
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 Performing utilization review for DRG cases and FFS cases with regards to and not limited to final bill review + consumables mark ups + non covered item/services + overutilization of services.
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 Performing review of claims as per CPT and ICD coding guidelines in line with insurance regulators (DHA,DOH/HAAD,MOH).
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 Adhering to the cost containment protocols for medical management cases.
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 Referring cases for second opinion when deemed necessary to confirm the best mode of management &ndash; also for cost containment to lesser Negotiating factor (NF) facilities within the member&rsquo;s network or option for home country treatment.
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 AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.
 
 
 </li>
 </ul>
 
 What You Bring
 
 
 
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 Bachelor&rsquo;s of Pharmacy / Dentistry / Medicine / Nursing / Physiotherapist / Paramedics
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 01-02 years of Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level
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 Physically fit to carry out duties.
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 Certified Medical Coder [Preferable]
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 Legally permitted to work in the country of operations.
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 Physically fit to carry out duties.
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 Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
 
 
 </li>
 </ul>
 
 How We Hire
 
 
 
 
 
 Agency Statement
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under
 
 
 contract. Any unsolicited submission will not be considered
 
 
 
 
 Key Benefits/What We Offer
 
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.
 
 
 At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.
 
 
 94031 | Customer Services &amp; Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
 
 
 Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and 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. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
 
 
 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.
 
 
 
 Great to have you on board.
 
 Let's care for tomorrow.
 
 
 Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz&lsquo; company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.
</div>

Medical Claims Officer

Join Nextcare and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Nextcare

About Company

Data Intelligence and Reporting

Medical Advisor - French

Medical Claims Officer