at HSBC
OtherPosted 6 days ago
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**Manager, Medical Claims Analytics & Gen AI Enablement** leads data-driven fraud checks, identifies trends, and provides actionable insights for cost containment in large medical claims datasets. Develops and maintains business scorecards using QlikView and Power BI. Champions AI initiatives, collaborating with stakeholders to implement machine learning and generative AI solutions. Requires a Bachelor's degree in relevant field, experience in medical claims analysis, proficiency in Python, Excel, and visualization tools. Strong analytics, communication, and interpersonal skills are essential. Mandarin or Cantonese is preferred.
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Full Job Description
GCB 5
We are currently seeking a high calibre professional to join our team as a Manager, Medical Claims Analytics & Gen AI Enablement.
In this role you will:
- Lead data driven Fraud, Waste & Abuse (FWA) checks using advanced analytics to identify anomalies, trends, patterns of abuse and insights for cost containment in large sets of Employee Benefits (EB) & VHIS Claims
- Deliver management reporting on Claims KPIs, providing actionable insights and recommendations in a timely & accurate manner
- Dashboards & Visualization: Create & maintain business scorecards through visualization tools such as QlikView & Power BI to support decision making process
- As an AI champion within the team, identify manual/repetitive workflows and MI that can be automated using AI and data analytics
- Compliance & Standards: Ensure all data analytics and reporting activities adhere to relevant regulations & standards.
- Collaborate with business stakeholders, internal & external technology teams, data teams to build & implement Machine learning & Gen AI solutions which will aid business in operational efficiency & FWA detection
- Collaborate with medical community and the insurance industry to generate meaningful insights from industry
To be successful you will need:
- Bachelors degree in Data Science, Statistics, Actuarial Science, Computer Science, Business analytics or related field. A masters degree is a plus
- Prior experience in data analysis & reporting in insurance industry preferably in medical claims/Pricing
- Proficiency in Python, Excel (including Pivot tables, macros), Power Point is required
- Experience in visualisation tools such as Power BI, Tableau, QlikView
- Familiarity with large language models (LLMs) and Generative AI applications in claims
- Strong analytics skills with ability to extract, collect, analyse data with speed and accuracy. Excellent skills in data story telling & articulate insights to management
- Effective communication and interpersonal skills, with excellent stakeholder management skill. Good command of written and spoken English. Mandarin or Cantonese is preferred.
- Results orientated, self-directed and motivated change leader
Opening up a world of opportunity
http://www.hsbc.com/careers
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