Manager, Medical Claims Strategy and Operations

4 days ago


Kuala Lumpur, Kuala Lumpur, Malaysia Prudential Hong Kong Limited Full time

The Manager, Medical Claims Strategy and Operations is responsible for Medical Claims Fraud, Waste and Abuse (FWA) detection and Claims Avoidance Rate in Prudential to ensure long-term sustainability of the portfolio. This role requires strong knowledge in medical and insurance processes, as well as excellent leadership and communication skills.

Responsibilities:
  1. Perform regular reviews of underwriting guidelines to ensure that they are relevant, competitive, and drive operational efficiency while maintaining good risk management and long-term sustainability of the portfolio.
  2. Leverage internal & external data to understand the current state, trends, and opportunities in improvement/growth areas.
  3. Develop and maintain rules in the claims system for STP and identify opportunities that provide operational efficiency, support business growth, and seamless customer experience.

We are committed to making Prudential a place where you can Connect, Grow, and Succeed.



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