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Mexico City, Mexico
El Rol
• Auditar las métricas establecidas con el prestador con el fin de garantizar el cumplimiento de los servicios: Ej. Reembolsos, tiempos de respuesta CAT, Suficiencia de Red, asesoría a los asegurados, etc
• Establecer planes de trabajo para modificar o mejorar los servicios brindados por el prestador.
• Revisar que los servicios cumplan con los tiempos y costos autorizados.
• Verificar la suficiencia de prestadores en la red médica.
• Analizar los costos médicos, identificar oportunidades y mejorar en la gestión del gasto.
• Valorar los programas de prevención de la salud de acuerdo a la población y siniestralidad.
• Realizar visitas a los módulos de atención médica para garantizar una atención de calidad.
• Seguimiento y acompañamiento de los dictámenes de invalidez.
• Revisión de excepciones y escalamientos.
Los Requerimientos
• Mínimo 5 años de experiencia en el sector asegurador o administradora médica, responsable ante el cliente es un plus.
• Éxito demostrable manejando estrategias y herramientas de gestión del gasto y servicio al cliente.
• Experto en identificar áreas de oportunidad y establecer planes de trabajo y mejora continua.
• Habilidades excepcionales de trato con el cliente; habilidad para desarrollar relaciones de trabajo rápidamente y maximizar recursos eficientemente para el logro de objetivos.
• Habilidad para organizarse y ser flexible.
• Fuertes habilidades analíticas y capacidad para brindar soluciones al cliente.
• Competencia en Microsoft Office, en especial en Excel.
• Título de licenciatura como Médico General, deseable maestría en administración o salud laboral.
Igualdad de oportunidades en el empleo
Thank you
Thank you
Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Willis Towers Watson are considered property of Willis Towers Watson and are not subject to payment of agency fees. In order to be an authorized Recruitment Agency/Search Firm for Willis Towers Watson, any such agency must have an existing formal written agreement signed by an authorized Willis Towers Watson recruiter and an active working relationship with the organization. Resumes must be submitted according to our candidate submission process, which includes being actively engaged on the particular search. Likewise, for our authorized Recruitment Agencies/Search Firms, if the candidate submission process is not followed, no agency fees will be paid by Willis Towers Watson. Willis Towers Watson is an equal opportunity employer. If you would like to have your contact information saved for future consideration, please email: Agency.inquiries@willistowerswatson.com.
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