Medical insurance and Assistance Doctor

We are seeking a dedicated and experienced Doctor to join our team as Medical insurance and Assistance Doctor, focusing on twomain areas:the International Private Medical Insurance (IPMI) business and the Medical Assistance business.The ideal candidate will have a strong medical background and a passion for providing high-quality patient care. This position requires working five days a week, fromThursday to Monday, includingweekend
and include night shifts (on call).  

Responsibilities: 
 

Medical Insurance Doctor – case manager for the IPMI Business
 

• Ensure the medical appropriateness of treatment plans through adherence to evidence based- medicine for IPMI business.  

• Recognize situations where this is necessary to collaboratively challenge a provider and articulate effective communication strategies.  

• Challenge Doctor or medical provider (by email or call) when necessary to ensure the treatment plan is the best to treat the condition.  

• Communicate with the member or broker (by email or call) to explain the coverage decision on specific cases.  

• Engage members in their care journey by providing expert guidance, discussing alternative treatment options and facilitating access to second medical opinions when necessary.  

• Execute case management tasks to ensure timely progress and resolution of cases.  

• Actively participate in innovative cost containment initiatives by identifying and addressing instances of overutilization, over prescription and potential fraud, waste or abuse.   

• Anticipate future costs and take actions to prevent recurrence or complication of chronic diseases. Apply strategic thinking to optimize treatment plans and patient outcomes.  

Coordinating Doctor for Assistance business
 

• Provide medical assessment for April Assistance cases and formulate the appropriate medical/travel recommendations and clearly documented action plans  

• Engage in verbal and written communication to obtain key information from, or provide essential updatesto, stakeholders involved in the April Assistance case, including but not limited to medical providers, members, and clients.  

• Identify and provide appropriate medical referrals within April Assistance Thailand’s coverage area upon request.   

In both activities
 

• Prepare well-structured and concise case summaries as part of the escalation process, ensuring all relevant information is included.  

• Recommend high-quality medical providers and specialists when there is a specific request from a client or team or for steerage cases.  

• Contribute to the medical audit and quality assessment of existing and prospective healthcare providers within the APRIL network, ensuring a standard of excellence in care delivery.  

• Assist any other team who need medical expertise and collaborate with them to provide high-quality services to clients.  

• Ensure the continuity of the business and handover cases to the other team members.  

Qualifications: 

• Medical degree with a valid license to practice.  

• Strong clinical skills and the ability to make informed medical decisions.  

• Excellent communication and interpersonal skills.  

• Ability to work effectively in a fast-paced and dynamic environment.  

• Proficient in English (verbal + written) - multiple languages is a plus.  

Working Arrangement: 

• Friday - Tuesday 

• Workinghours : 8:30 AM - 5:30 PM  

• Saturday - Sunday will need to be in the office 

• Join the weekend night shift 

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