Medical AdviserClaims Manager - Medical Advisory Services SA

About Avant

Avant is Australias leading medical defence organisation with a proud heritage of protecting Australian medical professionals for over 125 years.

Avant now represents 85000 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 nonGP specialist on a parttime 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 Avants 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 Avants 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 medicolegal roster.
Educate members staff and external stakeholders in medicolegal 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 understanding 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.
For further information please contact Nico Touze Head of Talent Acquisition at