Our client is a leading international insurance and risk-management group operating across Africa, the Middle East, and Europe. The company specializes in health, life, and protection solutions, supporting multinational clients through a network of regional offices and medical teams. They are seeking a Résponsable Surveillance Médicale to ensure consistency, performance, and compliance of medical practices across their subsidiaries.
Responsibilities
- Analyze the activities of the medical departments of the subsidiaries.
- Monitor practices applied in medical case management and in the medical control of claims invoices.
- Ensure the proper application of medical protocols by medical advisors.
- Support medical teams in improving their performance indicators.
- Participate in projects, notably the health system tool overhaul project, as well as other initiatives aimed at improving Health operations and developing integrated expertise.
- Provide input and support the process of formalizing performance indicators.
- Participate in compliance missions, inspections, controls, and evaluations.
- Analyze existing systems and propose improvements to combat fraud and abuse.
- Participate in meetings with clients when required.
Qualifications
- Doctorate in Medicine or Pharmacy (mandatory).
- Minimum 5+ years of experience as a practicing physician.
- Minimum 5+ years of experience in health management (TPA environment).
- Strong knowledge of claims management processes is an advantage.
- Solid understanding of public health systems and healthcare practices.
- Fluency in French is mandatory; English proficiency required.
- Willingness to travel frequently across Africa.
Skills & Competencies
- Understanding of the medical practice environment and best practices.
- Knowledge of professional ethics and deontology in healthcare professions.
- Ability to work in a multicultural environment.
- Proficiency in analytical and statistical tools (Excel, Power BI, etc.).
- Ability to identify specific issues, anticipate challenges, and take initiative in sensitive and urgent contexts.
- Ability to synthesize and leverage complex case files.
- Demonstrate rigor, responsiveness, a strong sense of public service, and professional discretion.
- Exhibit independence of thought and judgment.
- Adaptability and flexibility.
- Critical thinking.
- Autonomy and initiative.
- Team spirit.
- Ability to provide written and oral advisory within defined timelines.
- Strong ability to communicate and educate (pedagogical skills).
Schedule
- Monday to Friday
- 8:30 AM - 5:30 PM / 9:00 AM - 6:00 PM
Benefits
- 13 months pay
- Insurance
- Bonus based on KPIs
- Travel allowance