Medical Adviser/claims Manager

About Avant
Avant is Australia’s leading medical defence organisation with a proud heritage of protecting Australian medical professionals for over 125 years.
Avant now represents 85,000 health practitioners and medical students across every state and territory, delivering market leading products and services to meet their professional, personal and practice needs. Building on this heritage, our vision is to be the most trusted professional partner in supporting doctors throughout their lives and careers.
As a mutual organisation, owned by members and run purely for their benefit, our members are at the centre of all we do. As well as providing products and services to our members, we play a broader community role by advocating for improvements in the healthcare system and in quality, safety, and professionalism in medicine, through delivering education and research activities.
About the Role
Medical Advisor/Claims Manager is a combined role. The role of the Medical Advisor is to provide medical advice and expert opinion to inform business decisions within the Claims Department. The role of the Claims Manager is to manage a small portfolio of claims.
As part of the role, the Medical Advisor/Claims Manager contributes to special projects and initiatives as the need arises, writes articles, undertakes presentations and represents Avant and members at medical forums.
We are currently looking for a GP or non-GP specialist, on a part-time basis
**The principal purposes of the position are to**:

- Provide medical advice and expert opinion to the Claims Department and legal team as well as support for the members
- Manage a portfolio of claims sufficient to understand claims processes and current trends but still enable provision of medical and expert review
- Provide ongoing education to members, staff, and external stakeholders via Avant’s business units
- Participate in special projects and initiatives, as required.

**Key Challenges**:

- Provision of accurate and timely medical advice into aspects of claims management
- Maintaining up to date knowledge of medical practice and the medical environment
- Analysis and reporting of trends in medical practice and legislative reforms (if any) to best position Avant to meet future needs
- Analysis of Avant systems/processes to improve delivery of claims management service
- Achieving Avant’s preferred culture of a high performing organisation with ‘the right people in the right roles with the right competencies for the right outcomes for our members’.

**Key Accountability for the role includes**:

- Provision of timely medical advice and guidance to Claims Managers, Avant Law and external legal providers on medical issues related to claims and claims management.
- Proactive approach in the management of a claim, including reviewing the clinical documentation, strategy and providing strategic input into the management of the claim.
- Manage a portfolio of claims and participate in the medico-legal roster.
- Educate members, staff, and external stakeholders in medico-legal, clinical risk and claims matters.
- Provide professional input into the definition and achievement of the Claims department plans, goals and objectives.
- Provide review of relevant claims for committees.

**To be successful you will have**:

- Medical degree (MBBS or equivalent) and specialist qualification
- Post graduate qualification in medical, legal or insurance is preferred
- Detailed knowledge of the medical industry and the medical indemnity legal system
- Medical industry experience
- Clinical experience, PGY > 10 years preferred
- Insurance / claims experience ideal
- Legal system experience ideal
- Attention to detail
- Pragmatic and proactive
- Time management skills
- Excellent interpersonal and relationship building skills
- Excellent verbal and written skills and advocacy skills
- Proactive approach to developing relationships and under-standing customer requirements

At Avant, our people are the centre of everything we do for our members. We offer a range of benefits and opportunities to enable you to make a difference, learn, and grow in your career.