Medical Advisor - International Health

at  Allianz Partners

EXPERIENCE AND QUALIFICATIONS:

• Tertiary qualifications recognised by the regulation authority (AHPRA) as a registered nurse and experience in the primary health care sector
• Emergency nursing experience is highly regarded but not essential
• A commitment to ongoing professional development.
• Ensure nursing registration remains current and restrictions free.

ESSENTIAL SKILLS:

• Excellent PC skills (keyboard entry/accuracy) including basic knowledge of Microsoft word, excel and PowerPoint programs
• Possess excellent verbal, non-verbal and written communication skills when dealing with different levels of staff throughout Allianz Partners as well as individuals external to the department.
• Good problem-solving capabilities with an advanced diagnostic and methodical approach.

WHAT YOU DO

The Registered Nurse (RN) will play a key role within the International Health (OSHC & OVHC) team. The RN will be responsible for reviewing and adjudicating all medical claims, request for treatment and Guarantee of Payments including monitoring all high-cost cases (HCCs) (claims over $50K), while operating within policy and procedure guidelines. The RN will also provide support, direction, and education to non-clinical personnel within Allianz Partners.
As part of their role in the International Health (OSHC & OVHC) team, the RN will be accountable and responsible for liaising with medical providers in both the Private and Public sectors to determine appropriate rates and charges for treatment and identifying opportunities for cost containment.