Claims Operations Lead

**Who we are**

Amplify Health Asia Pte. Limited (Amplify Health) is a leading health technology and analytics organisation, providing our customers with integrated solutions to improve outcomes for individuals and the sustainability of health systems.

We aim to be a trusted custodian of Asia's largest repository of health data, unifying financial, clinical, operational and behavioural data to empower our customers with insights that highlight opportunities to deliver better value and care outcomes.

**We’ve set a bold vision**

The vision for Amplify Health is to be a leading digital health technology and integrated solutions business.

**Our Culture and Values**

At Amplify Health, we believe in fostering a culture that embodies the spirit of Courageous Entrepreneurs. We are passionate and innovative individuals who continuously strive to push boundaries and think outside the box. We understand that calculated risks are essential for driving progress, and we view failures as valuable opportunities to learn and grow.

As Outstanding People, collaboration, learning, and growth are at the core of our values. We trust and rely on each other, working together as a unified team to achieve our goals. When success comes our way, we celebrate it as a collective achievement, and we are committed to improving and excelling together.

We firmly believe in the mantra of Discuss, Decide, Do. Listening is fundamental in our decision-making process, and we act promptly, ensuring accountability in everything we do. Simplicity is the key to our efficiency, and we get things done quickly and effectively while being guided by facts and understanding.

At the heart of our pursuits lies a Lasting Impact. We prioritize the needs of our customers, and we are crystal clear about the problems we are solving for them. Progress is our north star, and while we strive for excellence, we acknowledge that perfection is a journey, and we remain focused on delivering excellent products that make a tangible difference.

If you are a passionate and innovative individual who thrives in a collaborative environment, where courage is celebrated, and customer focus is paramount, we invite you to join our team. Together, we will shape the future with our unwavering commitment to excellence and the determination to make a lasting impact in the industry.

**What you will do**

**Strategy Development and Execution**:

- Develop and implement a comprehensive strategy for Amplify Health to drive impactful transformation of claims operations for our clients, who are health care payors (private insurers, public payors, other payors) across the region in ensuring alignment with Client’s organisational objectives.
- Identify opportunities to optimize claims processing through organizational redesign, business model and process redesign, incorporating automation, technology adoption and also strategic partnerships.
- Drive initiatives to improve straight-through processing (STP) rates, reduce manual interventions, and enhance decision accuracy.

**Technology and Innovation**:

- Collaborate with AH’s product teams to design and deploy AH solutions.
- Collaborate with the client’s technology/data teams to ensure deployment of technology/data solutions are aligned with operational needs and changes to optimize the value in delivery.
- Work closely with technology teams to deploy AI-driven solutions for fraud detection, waste minimization, and claims adjudication.
- Oversee the integration of advanced analytics tools and predictive models to streamline claims workflows.
- Evaluate emerging technologies and partner with insurtech vendors to stay at the forefront of industry innovation.

**Process Optimization**:

- Lead initiatives to re-engineer end-to-end claims processes, focusing on operational efficiency and cost reduction.
- Implement best practices in medical claims management, including robust quality assurance and compliance frameworks.
- Develop and monitor KPIs to track transformation success and continuously improve outcomes.

**Stakeholder Engagement**:

- Collaborate with cross-functional teams, including underwriting, actuarial, provider management, and customer service, to ensure seamless claims operations.
- Serve as a key liaison between business stakeholders and technical teams to translate business needs into actionable solutions.
- Engage with external stakeholders, including providers and regulators, to align transformation efforts with industry standards and requirements.

**Change Management**:

- Lead organizational change efforts to foster a culture of innovation and adaptability within the claims team.
- Provide training and support to ensure smooth adoption of new processes and technologies.
- Communicate transformation goals, progress, and outcomes to leadership and other key stakeholders.

**Fraud, Waste, and Abuse Management**:

- Implement advanced solutions to detect, prevent, and mitigate fraud, waste, and abuse (FWA) in medi