Full Time 12 Months Fixed Term Contract positionHybrid role based in our Dublin City Centre offices/Cork Office
Fitness & Probity
This role is a ‘controlled function’ as defined by the Central Bank Reform Act 2010 Regulations 2011. Any appointment will be conditional on the company being satisfied that the appointee meets the requirements as set out in the Fitness and Probity standards issued by the Central Bank. This requires the company to complete prescribed due diligence to assess the appointee’s fitness and probity. Further details on this due diligence process are available from ILFS Human Resources.
What we offer
We have embraced a hybrid working model for most of our positions, which means that you can enjoy a balanced approach of working from home for part of the week and working from the office for the remainder of the week.
We offer a comprehensive benefits package including competitive salaries and bonuses, robust Learning and Development support, excellent Defined Contribution pension and comprehensive Wellbeing initiatives and support to name but a few.
Further details on our benefits package can be accessed here Benefits (life-careers.com)
Role Overview
Irish Life Health is seeking to appoint a Nurse Specialist to join our Clinical Services team. Reporting to the Clinical Services Manager, this role will provide clinical expertise to support the business and deliver on claims cost containment objectives.
The Nurse Specialist will manage hospital claims from a clinical perspective, ensuring alignment with best practice standards. A key part of the role involves building and maintaining strong relationships with hospital groups and other medical providers.
We are looking for a candidate with a strong clinical and commercial focus, excellent business acumen, and the ability to work independently. This is an exciting opportunity to grow your career, enhance your skills, and gain exposure to other areas of the business.
The successful candidate will be:
A Registered General Nurse with a minimum of 5 years recent acute clinical experience in areas such as critical care, A&E, oncology, surgical, or other acute settings.
Motivated to make a difference and play a significant role in achieving our business objectives.
Flexible and willing to take on new tasks as required to meet business needs.
Key Responsibilities
Clinical Technical Expertise – Decision making on health claims specific to medical appropriateness and to work closely with internal and external teams to ensure all decisions meet clinically appropriate standards.
Problem Solving and Decision Making – Recognises problems, consults, and collaborates with others to resolve issues & can work collaboratively with others to deliver the required result.
Quality, Controls, Governance and Reporting - Identify where existing processes are high risk, ineffective, inefficient, or cumbersome and elevate, with recommendations to improve.
Development and continual improvement of our patient care pathways.
Working as part of our clinical review team and advocate best clinical practice, to deliver the best outcome for our customers.
Responsibility for Process & Procedure Governance within the Clinical Review team including Training.
Draft letters, papers and presentations in relation to the clinical area as required.
Provide support on hospital and non-hospital contracts when required.
Always represents self in a professional and ethical manner, complying with all applicable company policy and procedures.
Project management - support on project delivery as required to support our Future of Health strategy.
Work as part of the overall Claims Strategy and Provider Services team in the delivery of our team goals to support our members through their healthcare journeys.
Skills & Experience
Must hold an active registration as Registered General Nurse with the NMBI.
One of the following qualifications, or a willingness to work towards qualification for:
PMI Dip, CIP, ACII or QFA.
A general understanding of the Health Insurance Industry.
Experience of analysing, managing and resolving complex issues and complaints.
Be a self-starter and willing to act on own initiative.
Managing a demanding workload with an ability to prioritise effectively.
Act as part of a team and give full participation and commitment to fellow team members to meet common goals.
Attention to detail and ability to drive initiatives to successful conclusion.
Proficiency in Microsoft software's.
Excellent interpersonal & communication skills.
Excellent verbal & written communication skills – the ability to write comprehensive and clear internal and external correspondence.
About us
Irish Life is one of Ireland’s largest financial institutions with a presence across a range of financial services markets and over 1.5 million customers. For over 80 years, we’ve been helping people to look after their life insurance, pension and investment needs, and more recently through Irish Life Health, their health insurance.
Irish Life Health provides Health Insurance to over 500,000 people across Ireland both directly and through Corporate schemes. Our Vision is to help people live healthier lives and we focus on providing access to healthcare solutions that will help our customers do this.
This includes offering services like 24/7 Digital Doctor; access to counsellors through our Healthy Minds programme and expert Physio support for acute back or neck pain across all of our Plans.
The company reserves the right to draw up a shortlist as part of the selection process. Where Agency assistance is required the Irish Life Recruitment Team will engage directly with suppliers. Unsolicited CVs / profiles supplied to Irish Life by Recruitment Agencies will not be accepted for this role.
Irish Life is proud to be an Equal Opportunities employer. We have created an environment of inclusion and growth to help people achieve their potential, to ensure they can bring their whole selves to work and to feel valued. We celebrate diversity of thought and perspective and want all of our employees to feel valued, respected and supported.
We have built a culture that promotes equality and inclusion for all of our current and future employees and strive to ensure that our behaviours, processes and practices are aligned to this culture.
If you require any accommodations during the recruitment process please contact lifecareers@irishlife.ie and we will be delighted to ensure you are fully supported to be your best.
Irish Life Health supports Equal Opportunity and is regulated by the Central Bank of Ireland.
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