AI Process Manager – Health Claims

Stack

Responsibilities

• ▹Develop health claims processes further through project work and day-to-day operations, with a focus on applying modern AI models
• ▹Coordinate closely with central units, initiate and run quantitative process analyses in health claims
• ▹Prepare business requirement specifications, contribute to concept design, model development and validation, and conduct and sign off on business testing
• ▹Create and maintain database queries (e.g. SQL, QMF) and handle reporting and statistics tasks
• ▹Use data to identify cost drivers and payout clusters in processing workflows, interpret analysis results from a business perspective, and develop practical process-optimization proposals

Requirements

• ▹Outstanding degree in insurance, mathematics, or computer science, plus IT experience or training in data management
• ▹Very good knowledge of processes across the health-segment value chain, complemented by health-economics knowledge and a basic medical understanding
• ▹High self-confidence, initiative, assertiveness, teamwork, and resilience as a basis for taking on project and line responsibilities
• ▹Excellent knowledge of relevant KPIs and confident interpretation of them for steering and optimization
• ▹Broad expertise in decision-support and controlling systems for operations, very good knowledge of tools used (e.g. Access), confident use of database query languages (e.g. QMF, SQL), and strong communication and data-visualization skills

Soft skills

What we offer

• ▹Flexible working hours, development opportunities, fair pay
• ▹Free hot drinks and water
• ▹Remote work possible for up to 50% of monthly working time

About the company

ERGO is one of the largest insurance groups in Germany and Europe, offering a dynamic environment and challenging tasks across a wide range of projects.