PURPOSE OF THE ROLE
Individual and Group Health jointly constitute Aviva Ltd.’s greatest risk.
The role reports into the Healthcare Management Committee, which currently controls all healthcare activity.
The need for effective and extensive clinical management has been identified as an essential to reverse a trend of IFRS losses and return both Healthcare portfolios to sustainable profitability without putting excessive upward pressure on price to client and to maintain Aviva Ltd.’s market positioning.
The role of the Medical Director is a full-time role, with 100% focus on this objective.
The individual is expected to develop clinical risk management strategy and operationalise a clinical capability to achieve the above objective. The individual will be required to influence and co-ordinate the efforts of other relevant parts/functions of the organisation to ensure this result.
To oversee the establishment of and then lead a new clinical division for Aviva Health Singapore, including:
Lead the development, implementation, and evaluation of clinical/medical programs.
Define and then undertake responsibility for activities related to the delivery of medical care and clinical services including but not limited to cost management, case management, utilisation review, quality assurance, network, contracting, pharmacy, clinical elements of service operations (claims) and medical protocol development.
Develop and manage a budget, including presenting monthly financial reports to practice staff with the support of administration.
Establish strategic vision and ensure stakeholder buy in before implementation.
Establish and then oversee clinical peer review.
Oversee documentation for and implementation of care planning
Manage relationships with clinical providers.
Convert strategy into practical and effective management.
Monitor quality and appropriateness of medical care.
Contribute to the overall Aviva Health strategy by participation in the Healthcare Management Committee.
Effective Risk Management/Governance
Monitor and evaluate clinical risk associated with interventions and operational activity.
Establish (together with our selected risk manager should such exist) a comprehensive set of clinical protocols defining best practice so as to both ensure quality outcomes for our clients as well as manage our claims’ expenditure.
Implement effective clinical protocols into our claims process in such a manner as to best manage the balance between push back from providers and attaining our goals in terms of quality outcomes and financial control.
Further develop the claims protocol set and intervention strategy so as to maximise benefit for clients and ourselves whilst respecting the dignity of medical professionals
Influence and where possible over time manage and ensure the implementation for our benefit of a vertically and horizontally integrated network by which we can control our patient pathways, outcomes, quality of experience and cost.
Interact with all levels of Aviva Health Singapore to ensure that the goals and benefits of the strategy are understood and supported.
Work with providers so as to achieve understanding and to try to develop common goals.
To establish and then lead a team of clinically qualified or trained individuals to fulfil the objectives of the newly established clinical division.
Master’s degree or higher in medicine
Valid license to practice medicine
10+ years’ experience in clinical medicine
5+ years’ experience in a hospital/ insurance administration role
5+ years experience in managed care
Familiar and comfortable with the use of data and analytics to gain insight, aid decisions and support actions.
Experience in dealing with Senior Leadership Teams (SLT)
Experience dealing with external consultants, third party administrators (TPAs), doctors, hospitals.