Medical Benefits and Insurance Officer

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Under the direct supervision of the Head of the Staff Pension and Insurances Unit, and the general supervision of the Chief, Staff Services Section, the incumbent participates in the management and administration of the Medical Benefits Fund, the Staff Compensation Plan and the commercial personal insurance policies offered by the Organization. S/he provides authoritative advice and interpretation of staff collective medical and insurance terms, monitors the implementation of procedures, identifies issues and develops policy revisions. S/he supervises, coaches and supports team members evaluating their performance as a team and individually, providing regular feedback and regular opportunities for development.

Medical Benefits Fund (MBF):

  • Provide expert advice and guidance to staff and management on Medical Benefits Fund.
  • Provide advice in sensitive staff cases, liaise and manage correspondence with the medical service, the third party administrator, Legal Affairs, the staff member and recommend appropriate action to senior management.
  • Identify issues that potentially affect MBF fund, procedures, and financial commitments.
  • Undertake analysis as required and provide data and advice to management on matters which affect staff rights and the potential commitment of MBF funding.
  • Provide data and clarifications for actuarial studies and provide information to financial auditors for audit purposes BFM.
  • Manage the contract and relations with third party administrator(s) and ensure corresponding implementation in the regulatory framework, work procedures and internal systems.
  • Liaise with third party administrator to improve communication with voluntary and compulsory members via a range of channels. Initiate administrative action for processing claims (Article 19 of the MBF Rules) against third parties in recovery of sums for the Organization.
  • Participate in  the  MBF Board meetings and prepare reports of proceedings and support working groups as necessary.
Staff Compensation Plan:
  • Provide expert advice and guidance to staff and management on Staff Compensation Plan.
  • Prepare background analysis and documentation on cases to be brought before the Advisory Committee on Compensation Claims in liaison with the Medical Doctor and Legal Affairs where necessary.
  • Studies and analyses compensation claims by staff members in order to advise the Head of Unit to take appropriate action according to the specific cases. Undertake analysis of contentious cases for the purpose of settling compensation claims with insurers.
  • Initiate administrative action for processing claims (Article 8 of the Compensation Rules) against third parties in recovering of sums for the Organization.
  • Supervise the maintenance of the associated accounts and the preparation of  reporting on activity.
Other Responsibilities:
  • Provide expert advice and guidance to staff and managers on insurance plans available and conditions.
  • Manages specific and/or contentious cases with staff/visitor and with insurance company. Prepare statistics and analysis for accountancy purpose and/or for insurance company attention.
  • Implements a continuous improvement approach to the systems, processes and procedures liaising with external stakeholders such as insurers, the Pension Fund, the third party administrator and internal stakeholders inside HRM and in UNESCO to do so.
Required Qualifications:

Education:

  • Advanced university degree (Master’s or equivalent) in Finance, Business Administration, Human Resources Management, Public Health or related fields.
Work Experience:
  • Minimum four (4) years of relevant professional experience in  Social Security Benefits, Medical Insurance Contract Management, Staff Compensation, Human Resources management, Financial Services or Legal matters.
  • Experience in health insurance scheme management or administration in the UN System or similar international organisations.
  • Experience managing internal and external stakeholders.
Skills and Competencies:
  • Strong verbal and written communication skills.
  • Strong knowledge of employee insurance schemes and/or benefit programmes.
  • Strong problem-solving, research, and analytical skills.
  • Ability to create compelling and informative presentations and reports.
  • Integrity and the ability to work with confidential information with discretion.
  • Outstanding customer service skills.
  • Excellent organizational skills, sound judgment, willingness to take initiative and the ability to work independently and as part of a team.
  • Excellent IT skills and knowledge of MS Suite.
Languages:
  • Excellent knowledge (written and spoken) of English or French, and good knowledge of the other.

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