Director, Medical Officer

Prudential’s purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners. We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions. We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

Aim to drive a seamless onboarding process with a top-tier underwriting (UW) and claims framework for long-term portfolio sustainability, enhance customer experience through swift and quality UW decisions, and manage medical business and health portfolio sustainability with stakeholders. Additionally, focus on improving customer experience at panel hospitals and clinics, supporting operational efficiency, and balancing claims decisions and FWA through automation. We also aim to develop skills for complex medical areas, introduce new health-related offerings, support health product development, leverage AI and analytics for growth, and deliver initiatives aligned with the Group Health strategy, while participating in industry committees related to MHIT.

Principal Duties & Responsibilities

• Support competitive UW & claims decision & create opportunities for growth
• Increased NB by driving seamless process via straight through process
• Support long term sustainability of health portfolio through robust underwriting, endorsement and revival via sustainable UW & Claims policies
• Support long term sustainability of health portfolio through robust Claim guidelines & framework
• Support Claims FWA projects and initiatives.
• Drive Automation & increased usage of AI in the areas of health
• Support improvement in onboarding & Claims NPS for health portfolio
• Support assessment of complex medical scenarios for all areas of Ops NB, Claims and post-claims UW
• Drive Medical Training to all areas of Ops and Health team as required
• Panel Hospital Management in areas of medical cost containment and hospital network optimization. Including management of panel doctors.
• Panel clinic management for UW
• Support fast & quality service at panel hospital & minimize complaints
• Compliant Hospital Management process (TPRM)
• Promote wellness & connected care in line with group strategy
  
  
  

Qualifications

JOB SPECIFICATION:

• Medical or equivalent
• MBBS or equivalent
  
  
  

Experience

• At least 10 years of experience in Insurance Industry
• Experience in Risk Management – 5 years
• Experience in New Business, Claims related area – 5 years each
• Experience in Data Analytics – 2- 3 years
  
  
  

Knowledge

• Medical Knowledge
• Insurance Product Knowledge
• Risk Management
• Data Analytics
• Claims and Underwriting
  
  
  

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.