Gruppenleiter/in Wirtschaftlichkeitsprüfung / BVM 80-100% — CSS Versicherung

Full description

With your team, you ensure that invoices, tariffs and suspected cases are carefully checked and that incorrect or abusive behavior is not undetected. In this leadership role, you combine expertise, decision-making confidence and a good feeling for people. In this way, you make an important contribution to ensuring that benefits are assessed correctly, that funds are used effectively and that the interests of CSS and its insured are protected.

This is what your everyday life looks like

• At the heart of it: You ensure that performance and damage cases, invoices and tariffs are systematically checked and incorrect, uneconomic or abusive claims are handled cleanly.
• You prioritize suspected cases, clarify them in a structured manner and initiate the necessary steps together with internal specialist offices and external partners.
• In everyday life, you control the operational goals in the area of WP-BVM and intervene when corrections are necessary in terms of quality, priorities or resources.
• Executives, employees and external departments advise you on questions relating to economic audits as well as abuse and fraud prevention.
• From individual cases, hints and data analyses, you will recognize patterns and develop effective approaches for further case management.
• With clean documentation, reliable statistics and regular reporting, you create transparency about the benefits and impact of WP-BVM activities.

You bring that with you

• First things first: You bring several years of leadership experience and lead clearly, reflectively and with coaching competence.
• Your experience backpack includes well-founded practice in abuse, fraud or profitability testing – ideally in the insurance environment or in a criminal, legal or medical context.
• You deal with legal issues safely and know the relevant basics in health insurance, social security, civil and criminal law.
• Analytical thinking is one of your strengths, and with Excel, Word, PowerPoint and appropriate analysis tools you work safely.
• You decide solution-oriented, set clear priorities and optimize on your own initiative.
• In German and/or French you express yourself well orally and in writing. Italian, English or an existing network in fraud management are a plus.
• Work Flexible: Adapt your work to your lifestyle annually with part-time options and other flexible models like home office and more.
• Enjoy your wallet: Benefits such as bonus, Reka, discounted health insurance premium and others that quickly make up a few thousands a year.
• Improve yourself further: We like to see it if you educate yourself internally or externally and support generously with time and money.
• Stay fit: Ergonomic workplaces, promotion of mental well-being and many other offers around your health.
• Celebrate with us: Focused work and celebrate. We love this combination and maintain it regularly.
• Enjoy your family life: Make time for your offspring: 3 weeks for fathers, for mothers up to 20 weeks. There are also generous child and education allowances.

Contact details

Questions about your job to your manager? Judith Knutti is here for you. +41 58 277 42 28

Questions about the application process? Chantal Hügli is here for you. 058 277 60 33

Your future team

Around 1.7 million customers, around 100 agencies, around 3000 employees and one of the leading Swiss health and property insurers. Yeah, we're pretty big. Fortunately. Because it also gives us great opportunities to really make a difference. Our roots date back to 1899. Since then we have grown healthy, but we do not rest on this: We still have a lot of plans for the future - maybe together with you?

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