Manager, Medical Claims Analytics & Gen AI Enablement
Foreign bank · Large bank
Kowloon CityOn-site
Role overview
GCB 5
We are currently seeking a high calibre professional to join our team as a Manager, Medical Claims Analytics & Gen AI Enablement.
In this role you will:
Lead data driven Fraud, Waste & Abuse (FWA) checks using advanced analytics to identify anomalies, trends, patterns of abuse and insights for cost containment in large sets of Employee Benefits (EB) & VHIS Claims
Deliver management reporting on Claims KPI’s, providing actionable insights and recommendations in a timely & accurate manner
Dashboards & Visualization: Create & maintain business scorecards through visualization tools such as QlikView & Power BI to support decision making process
As an AI champion within the team, identify manual/repetitive workflows and MI that can be automated using AI and data analytics
Compliance & Standards: Ensure all data analytics and reporting activities adhere to relevant regulations & standards.
Collaborate with business stakeholders, internal & external technology teams, data teams to build & implement Machine learning & Gen AI solutions which will aid business in operational efficiency & FWA detection
Collaborate with medical community and the insurance industry to generate meaningful insights from industry
To be successful you will need:
Bachelor’s degree in Data Science, Statistics, Actuarial Science, Computer Science, Business analytics or related field.
A master’s degree is a plus
Prior experience in data analysis & reporting in insurance industry preferably in medical claims/Pricing
Proficiency in Python, Excel (including Pivot tables, macros), Power Point is required
Experience in visualisation tools such as Power BI, Tableau, QlikView
Familiarity with large language models (LLM’s) and Generative AI applications in claims
Strong analytics skills with ability to extract, collect, analyse data with speed and accuracy.
Excellent skills in data story telling & articulate insights to management
Effective communication and interpersonal skills, with excellent stak...
Experience: Entry level
Connect with an insider to learn more about this role (team culture, interview focus, and how to stand out).
Requirements
Relevant degree or professional qualifications
Experience aligned with the role level stated in the posting
