Specialist Medications Trust Medical Service (m/f/d), 80-100%

About the job

Health Insurance Solutions AG is a performance support centre for health, social and private insurers founded in 2024. With high-quality and efficient services from a single source, we support our customers and partners in optimising their claims processes and successfully developing further in the insurance market. To strengthen our Trust Medical Service team, we are looking for a specialist immediately or by arrangement:

Specialist Medications Trust Medical Service (m/f/d), 80-100%

Your Role

In our team of medical specialists, you will fulfil a demanding role with a broad and interesting field of work. You will apply your expertise specifically in insurance medical assessments and support well-founded claims decisions. As an important contact person for insurers, you clarify complex medical issues and ensure transparency as well as comprehensible evaluations. Furthermore, you actively contribute to knowledge transfer within the company, develop professional standards and support the continuous development of our specialist team.

Your Tasks

• You process insurance medical assessments based on medical reports and in collaboration with the trust doctors.
• You assess and draft recommendations regarding the obligation to provide benefits based on the legal foundations of the Health Insurance Act (specialities list and Swissmedic).
• You make independent decisions while respecting data protection and personal rights.
• You are an important contact person for insurers as well as internal and external stakeholders on questions concerning medications and insurance medical assessments.
• You support knowledge transfer within the company and to external partners and contribute to professional development.
• You develop internal guidelines and procedures for the specialist team and ensure their practical implementation.
• You share responsibility for maintaining, updating and further developing our internal knowledge database (WIKI).

Your Profile

• Completed training as a nursing specialist (HF / FH) or MPA with several years of clinical experience.
• You think proactively, act independently and approach challenges proactively and solution-oriented.
• You convince with your negotiation skills and confidently and reliably represent yourself to various stakeholders thanks to your high social and team competence.
• Further training in the commercial or health/social insurance sector is an advantage.
• You speak German as your first language and have good knowledge of French.

What We Offer You

• A motivated and committed team with flat hierarchies and short decision-making paths.
• A modern working environment in the latest office premises in the heart of Bern.
• A great deal of personal responsibility and scope for design.
• Attractive training opportunities, numerous benefits and the possibility to work from home.

Do you have questions? Tanja Emmenegger, Specialist Manager Medications, is happy to assist you with any questions at 031 359 19 45.

Are you ready? Then let’s grow together! Send us your application with CV, diplomas and references via jobs.ch. We look forward to getting to know you!