[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"job-sr-specialist-aagi-ah-hospital-claim-audit-allianz-insurance-en-th":3},{"id":4,"slug":5,"title":6,"description":7,"company":8,"is_featured":12,"featured_until":7,"is_active":13,"deactivated_at":7,"is_enriched":13,"processed_job_posting_json":14,"processed_latitude":69,"processed_longitude":70,"processed_employment_types":71,"processed_working_hours":72,"processed_working_hours_labels":74,"processed_home_office":75,"processed_salary_min":66,"processed_salary_max":67,"processed_salary_currency":63,"processed_salary_source":76,"processed_benefits":77,"processed_benefits_labels":78,"processed_industry":79,"processed_skills":7,"processed_job_location":80,"processed_full_address_gmaps":82,"processed_street_gmaps":83,"processed_city_gmaps":84,"processed_postal_code_gmaps":85,"processed_country_gmaps":87,"processed_country_iso_code_gmaps":89,"full_description":17,"formatted_description":90,"processed_employment_types_labels":35,"processed_home_office_labels":33,"processed_industry_labels":37,"processed_it_skills":91,"processed_it_skills_labels":94,"processed_soft_skills":95,"processed_soft_skills_labels":97,"processed_job_expertise_skills":98,"processed_job_expertise_skills_labels":99,"processed_language_requirements":100,"processed_total_experience_years":96,"processed_professional_field":107,"processed_professional_field_labels":110,"processed_leadership_role":12,"processed_date_posted":20,"raw_job_url":111,"apply_url":7,"raw_hiringOrganization_logo_url":7,"translations":7,"canonical_industry_key":79,"canonical_industry_label":37,"max_cpc":112,"actual_cpc":7},70883,"sr-specialist-aagi-ah-hospital-claim-audit-allianz-insurance","Sr. Specialist - AAGI A&H Hospital & Claim Audit",null,{"name":9,"slug":10,"logo_url":11},"Allianz Insurance","allianz-insurance","https:\u002F\u002Fcdn.phenompeople.com\u002FCareerConnectResources\u002FAISAIPGB\u002Fimages\u002FHeader-1706868786965.svg",false,true,{"@context":15,"@type":16,"title":6,"description":17,"hiringOrganization":18,"datePosted":20,"validThrough":21,"jobLocation":22,"jobLocationType":33,"employmentType":34,"industry":36,"skills":38,"baseSalary":61},"https:\u002F\u002Fschema.org\u002F","JobPosting","\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Job Summary:\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">The position holder is responsible to ensure providers are providing the best possible treatment for Allianz and price guidelines with high levels of quality based clinical outcomes\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Key Responsibilities:\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Clinical Quality\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul style=\"margin-bottom: 0cm; margin-top: 0px;\">\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Develop and implement a clinical quality strategy, which assures our members that they are receiving high quality and appropriate care.\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Ensure that all treatment and care given to our members including admission to hospital is appropriate and in accordance with agreed protocols.\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Encourage clinical best practice by providing analytical feedback hospitals, clinics and doctors on clinical practice including procedural costs, length of stays and outcomes.\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Ensure that all hospitals and clinics in our network meet our standards of care and take necessary action when the care given is below standard.\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Ensure that any new clinical procedures, drugs or technology are appropriate and safe for our customers\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 8pt 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">To review and manage the treatment of high claiming members to ensure that their treatment is appropriate\u003C\u002Fspan>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Clinical Audit\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul style=\"margin-bottom: 0cm; margin-top: 0px;\">\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Carry out clinical audits on both provider network and non-provider network, ensuring that Allianz customer receive high quality and appropriate treatment and care at an affordable price.\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 8pt 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Retrospective review (Internal and External Audit).\u003C\u002Fspan>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Clinical Governance scheme\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul style=\"margin-bottom: 0cm; margin-top: 0px;\">\u003Cli style=\"margin: 0cm 0cm 8pt 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Attend the pool insurance meeting as schedule Attend claim and clinical committee as team member\u003C\u002Fspan>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"margin: 0cm 0cm 8pt; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cstrong>\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Must Have\u003C\u002Fspan>\u003C\u002Fstrong>\u003C\u002Fp>\u003Cul style=\"margin-bottom: 0cm; margin-top: 0px;\">\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Bachelor’s or master’s degree in Nurse Science\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">At Least 3-5 yrs of experience in Nurse in hospital and insurance industry experience will be advance\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Understanding of insurance databases \u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Experience in data collection, evaluation, and interpretation\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Experience in data analysis and data visualization tools (e.g. PowerBI, Tableau)\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Knowledge of collaborative project management tools (e.g. Trello, JIRA, Asana)\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 0cm 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Knowledge of Microsoft Office suite, Microsoft EPM, and MS Outlook\u003C\u002Fspan>\u003C\u002Fli>\u003Cli style=\"margin: 0cm 0cm 8pt 0px; line-height: 107%; font-size: 11pt; font-family: Aptos, sans-serif;\">\u003Cspan style=\"line-height: 107%; font-family: Calibri, sans-serif;\">Any AI-future skills e.g., ChatGPT, or CoPilot365, will be advantage.\u003C\u002Fspan>\u003C\u002Fli>\u003C\u002Ful>",{"@type":19,"name":9},"Organization","2026-09-14","2027-09-14",[23],{"@type":24,"address":25,"geo":29},"Place",{"@type":26,"addressLocality":27,"addressCountry":28},"PostalAddress","Bangkok","TH",{"@type":30,"latitude":31,"longitude":32},"GeoCoordinates",13.78333,100.51667,"ONSITE",[35],"PERMANENT",[37],"Insurance",[39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60],"PowerBI","Tableau","Trello","JIRA","Asana","Microsoft Office","Microsoft EPM","MS Outlook","ChatGPT","CoPilot365","Analytical Thinking","Communication","Collaboration","Attention to Detail","Clinical Quality Assurance","Clinical Audit","Insurance Claims Management","Data Analysis","Data Visualization","Project Management","Clinical Governance","Healthcare Provider Network Management",{"@type":62,"currency":63,"value":64},"MonetaryAmount","USD",{"@type":65,"minValue":66,"maxValue":67,"unitText":68},"QuantitativeValue",60000,90000,"YEAR",[31],[32],"permanent",[73],"FULL_TIME",[73],"onsite","estimated",[],[],"insurance",[81],"allianz, 10330, bangkok, thailand",[],[],[27],[86],"10330",[88],"Thailand",[28],"**Job Summary:**\n\nThe position holder is responsible to ensure providers are providing the best possible treatment for Allianz and price guidelines with high levels of quality based clinical outcomes\n\n**Key Responsibilities:**\n\n**Clinical Quality**\n\n- Develop and implement a clinical quality strategy, which assures our members that they are receiving high quality and appropriate care.\n- Ensure that all treatment and care given to our members including admission to hospital is appropriate and in accordance with agreed protocols.\n- Encourage clinical best practice by providing analytical feedback hospitals, clinics and doctors on clinical practice including procedural costs, length of stays and outcomes.\n- Ensure that all hospitals and clinics in our network meet our standards of care and take necessary action when the care given is below standard.\n- Ensure that any new clinical procedures, drugs or technology are appropriate and safe for our customers\n- To review and manage the treatment of high claiming members to ensure that their treatment is appropriate\n\n**Clinical Audit**\n\n- Carry out clinical audits on both provider network and non-provider network, ensuring that Allianz customer receive high quality and appropriate treatment and care at an affordable price.\n- Retrospective review (Internal and External Audit).\n\n**Clinical Governance scheme**\n\n- Attend the pool insurance meeting as schedule Attend claim and clinical committee as team member\n\n**Must Have**\n\n- Bachelor’s or master’s degree in Nurse Science\n- At Least 3-5 yrs of experience in Nurse in hospital and insurance industry experience will be advance\n- Understanding of insurance databases \n- Experience in data collection, evaluation, and interpretation\n- Experience in data analysis and data visualization tools (e.g. PowerBI, Tableau)\n- Knowledge of collaborative project management tools (e.g. Trello, JIRA, Asana)\n- Knowledge of Microsoft Office suite, Microsoft EPM, and MS Outlook\n- Any AI-future skills e.g., ChatGPT, or CoPilot365, will be advantage.",{"jira":92,"asana":92,"trello":92,"chatgpt":92,"powerbi":93,"tableau":93,"copilot365":92,"ms outlook":93,"microsoft epm":92,"microsoft office":93},2,3,[39,40,41,42,43,44,45,46,47,48],{"analytical thinking":96,"communication":96,"collaboration":93,"attention to detail":96},4,[49,50,51,52],{"data analysis":96,"clinical audit":96,"data visualization":93,"project management":93,"clinical governance":93,"clinical quality assurance":96,"insurance claims management":96,"healthcare provider network management":93},[53,54,55,56,57,58,59,60],{"detected_language_jobad":101,"required":102},"en",[103],[104],{"language":105,"level":106},"ENGLISH","C1",[108,109],"Health Services Managers","Insurance Claims and Policy Processing Clerks",[108,109],"https:\u002F\u002Fcareers.allianz.com\u002Fglobal\u002Fen\u002Fjob\u002F104750\u002Fsr-specialist-hospital-claim-audit-health-insurance",1]