Jobs in Philippines

Context:

Under the supervision of the Head, Occupational Heath Unit (OHU) in Geneva and in close consultation/coordination with the Chief, Human Resources Operations and Administrative Services/ Manila Administrative Centre (MAC), the successful candidate will be responsible and accountable for the Health Insurance and Medical Supervision (HIM) functions in Manila.

He/ she will be responsible for the review/ analysis of medical claims, for the monitoring of staff health and for authorization of medical evacuations and travel for medical reasons.

Core functions/ responsibilities:

Insurance and Health Claims Review

• Control with accuracy the insurance medical bills of participants, taking into account the diagnosis, the treatment and their amount in accordance with the locally prevailing rates and with the IOM medical insurance policies (i.e. Health Insurance, Medical Service Plan and Compensation Plan, etc); detect fraud and establish/strengthen control mechanisms to prevent fraud, mismanagement and to protect IOM's interests.

• Analyze and provide input on insufficient insurance coverage causing hardship to staff based on first-hand experience of reviewing medical claims and refer them to the HRM Staff Insurance Unit (STU) and to the OHU Medical Officer to evaluate and eventually discuss with the insurance providers; give input on where IOM instructions and rules may not be appropriate to prevent abuse.

• Provide explanations to any insured staff about decisions taken and ensure that the staff gets the full advantages with regard to the insurance regulations (e.g. for treatments requiring prior approval, for high medical expenses, for entitlement after cessation of participation, for treatment outside the duty station); request additional medical information and supporting documents when necessary. Negotiate participant's planned hospitalization with the hospital in case of expected high cost.

• Respond in a timely manner to specific queries from participants and staff concerning health or medical insurance issues, whilst maintaining strict medical confidentiality, in close coordination with the Health Claims Processing (HCP) MAC team, the HRM Senior Insurance Officer and the Head of the OHU.

• Ensure the screening of medical reports of the worldwide cases under the Compensation Plan, the United Nations Joint Staff Pension Fund (UNJSPF) and the UN Malicious Act Insurance; ensure that the decisions taken by local doctors are well documented; follow up on the evolution and submit to OHU with the supportive documents for final evaluation and for OHU to submit the request of a disability benefit.

Effective Occupational Health Support

• When required, provide medical assistance/aid in emergencies. Assist in dealing with the medical evacuation of staff worldwide in coordination with Chiefs of Mission and the OHU (or with the HIM Medical Officer in Panama in the absence of the OHU Medical Officer) in compliance with the insurance rules.

• Act on behalf of OHU with regard to any occupational health hazards for IOM staff. Undertake travel to missions upon OHU's request to assess local health care infrastructure and mission's working environment, as well as meet and clarify health and insurance issues with staff; report to OHU.

• Provide pre-travel briefing for Officials (except HQ's) in coordination with OHU.

Management of Medical Examinations

• Check medical examination reports; i.e. pre-employment Entry on Duty examinations (EOD), annual driver exams, Periodic Medical Exams (PME), exit exams, of all Officials (except those in Headquarters); follow-up on conditions; ensure that quality control in standards of health assessments are met in accordance with OHU-IOM requirements.

• Based on the analysis of the medical examinations, decide on staff's admission into the various insurance plans and on eventual exclusions or allow transfer from one insurance plan to the other. Screen all medical questionnaires of IOM eligible dependents entering the medical insurance. Evaluate if there are any exclusions upon entry, if there are any conditions limiting the staff's work capacity and authorize eventual extended insurance coverage upon exit (CACP).

Reporting and Documentation Management

• Submit monthly reports to OHU on any new high cost cases, CACP and exclusions and quarterly reports on all ongoing occupational events. Follow up on prolonged sick leave (to be shared with OHU upon request).

• Ensure that all medical files in HIM Manila and all documentation about medical insurance and data are well organized/processed; provide OHU with yearly statistics on staff's health (occupational & non occupational accidents and illnesses encountered, sick leave etc).

Perform such other duties that may be assigned.

Desirable Competencies

Behavioural

a) takes responsibility and manages constructive criticism; b) works effectively with all clients and stakeholders; c) promotes continuous learning: communicates clearly; d) takes initiative and drives high levels of performance management; e) plans work, anticipates risks, and sets goals within area of responsibility; f) displays mastery of subject matter; g) contributes to a collegial team environment; h) creates a respectful office environment free of harassment and retaliation, and promotes the prevention of sexual exploitation and abuse (PSEA); i) incorporates gender-related needs, perspectives, and concerns, and promotes equal gender participation; j) displays awareness of relevant technological solutions; k) works with internal and external stakeholders to meet resource needs of IOM.

Technical

a) effectively applies knowledge of health issues in execution of responsibilities at appropriate level; b) treats personal medical information of staff with utmost confidentiality.

Desirable Qualifications and Experience

a) completed doctorate in Medicine from an accredited academic institution in General or Internal or Emergencies Medicine (additional qualification in Occupational, Travel medicine an asset); b) eight years experience post doctorate in clinical and occupational health, including in the context of travel and tropical medicine; promotion of physical and mental health; experience with occupational health issues related to crisis and in developing countries; c) at least three years management/supervision: experience in general office administration; d) experience in medical insurances and health claim analysis; e) experience in administering medical evacuations; f) knowledge of legal and ethical issues related to occupational health care practice; g) experience in liaising with international organizations and hospitals in different countries an asset.

Languages

Fluent oral and written English and French. Working knowledge of Spanish an asset

How to apply:

Interested candidates are invited to submit their applications via PRISM, IOM e-Recruitment system, by August 16, 2011 at the latest, referring to this advertisement.

For further information, please refer to: http://www.iom.int/jahia/Jahia/pid/165

In order for an application to be considered valid, IOM only accepts online profiles duly filled in and submitted with a cover letter not more than one page specifying the motivation for applications.

Only shortlisted candidates will be contacted. You can track the progress of your application in your personal application page in the IOM e-recruitment system.

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