Medical Advisor (all)

Medical Advisor (all) #

80-100% in Winterthur ##

At SWICA, health is our focus. And this is exactly where your expertise will make a difference. As a medical advisor (male or female), you are an important medical authority and, with well-founded, independent assessments, you contribute to fair and comprehensible benefit decisions. In doing so, you operate at the interface of medicine, insurance, and law and work together with a wide variety of specialist departments.

A highly specialized activity awaits you with a lot of personal responsibility and professional scope for design, in which you assess complex medical issues and make an important contribution to high-quality healthcare. Together with an experienced team of specialists and medical advisors, you work in an appreciative environment with short decision-making paths and benefit from flexible working models that allow you to optimally combine work and private life.

This is how you shape health with ###

• You assess medical facts within the framework of social health insurance and prepare well-founded medical advisor statements
• You check benefit requirements according to KVG, taking into account the criteria of effectiveness, appropriateness, and efficiency (WZW)
• You assess requests for cost coverage for medicinal products, particularly in the area of off-label use according to Art. 71a-d KVV
• You conduct medical advisor examinations and provide advisory support to our benefit departments on medical issues
• You support the legal department with medical issues in connection with decrees, objections, and complaints
• You advise underwriting in the supplementary insurance business as well as other internal stakeholder groups on insurance medical topics
• You participate in the development of basic papers, standards, and insurance medical concepts
• Depending on interest and experience, you represent SWICA in specialist committees and industry organizations

What distinguishes you ###

• Specialist title and several years of clinical professional experience, ideally in General Internal Medicine or a comparable discipline
• SGV medical advisor certificate or the willingness to acquire it
• Several years of experience in insurance medicine or a strong interest in this field
• Enjoyment of complex medical issues as well as an analytical and solution-oriented way of working
• Interest in legal and health-economic contexts
• Strong communication skills and enjoyment of interdisciplinary cooperation
• Very good German skills as well as good knowledge of another national language and English

Your place of work ###

Zürcherstrasse 31, 8401 Winterthur