Head of Case Management and Medical Director
Head of Case Management and Medical Director
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Job Description
Head of Case Management and Medical Director
This leadership role provides medical leadership and expert physician advice across case management disease management and claims cost containment functions. It plays a pivotal role in enhancing the companys health capabilities through operational innovation digital transformation and clinical excellence. The incumbent is expected to lead complex initiatives influence cross-functional teams and ensure the company remains at the forefront of insurance medicine.
Responsibilities:
Contribute to the development of medical strategy for case management ensuring alignment with enterprise health objectives and regulatory standards.
Provide expert medical advice on underwriting and claims cases to support accurate decision-making and risk assessment.
Support the development of individualized care pathways integrating evidence-based practices to optimize patient outcomes and claims efficiency.
Establish and uphold rigorous medical review protocols across underwriting claims and quality assurance functions.
Serve as the organizations medical authority translating emerging medical science into actionable insights for insurance medicine.
Partner with underwriting claims product and actuarial teams to enhance medical risk assessment and product innovation.
Lead research initiatives on medical conditions relevant to insurance contributing to proprietary guideline development and global best practices.
Represent the medical and case management function in industry forums seminars and public relations engagements to reinforce brand credibility and thought leadership.
Support regional/global projects and ad-hoc initiatives as required.
Deliver expert medical advice and leadership for case management and health operational execution.
Ensure compliance with medical standards and regulatory requirements.
Collaborate with underwriting and claims teams to improve medical adjudication processes.
Contribute to enterprise transformation initiatives by integrating medical expertise into system design data analytics and operational workflows.
Required Qualifications:
Medical degree (M.D.) from an accredited institution; registered with the Medical Council of Hong Kong pursuant to the Medical Registration Ordinance (Cap. 161 of the Laws of Hong Kong).
Minimum 10 years of clinical experience across public and/or private sectors.
At least 3 years of direct case management experience in health insurance or re-insurance including utilization review and care coordination.
Solid understanding of claims operations provider management and underwriting processes.
Ability to provide medical advice on underwriting and claims cases with sound clinical judgement.
Strong analytical and communication skills; able to translate clinical insights into operational improvements for business impact.
Professional certifications (e.g. FLMI FLHC/ALHC FALU/AALU CLU) are advantageous.
Fluent in English and Chinese.
When you join our team:
Well empower you to learn and grow the career you want.
Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team well support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit is an Equal Opportunity Employer
At Manulife/John Hancock we embrace our diversity. We strive to attract develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment retention advancement and compensation and we administer all of our practices and programs without discrimination on the basis of race ancestry place of origin colour ethnic origin citizenship religion or religious beliefs creed sex (including pregnancy and pregnancy-related conditions) sexual orientation genetic characteristics veteran status gender identity gender expression age marital status family status disability or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process contact .
Working Arrangement
Required Experience:
Director
Employment Type
Full-Time
