22 Health Insurance jobs in Malaysia

ABOUT US

‘First’ is more than our name, it’s our nature. Cayman First is an industry-leading Property & Casualty and Health insurer, delivering best-in-class products and services to respond to the changing needs of individuals, households and businesses. Through our carefully selected network of agents and brokers, we provide protection for our customers today and prepare them for a brighter tomorrow. Cayman First maintains an A- (Excellent) financial strength rating from global credit rating agency AM Best.

PURPOSE OF JOB

We are seeking an experienced and dynamic Vice President – Health Insurance to lead our health insurance portfolio. In this executive role, you will oversee the full spectrum of operations including strategy, marketing, underwriting, administration, customer service, claims management, and overall profitability driving growth and excellence across the business.

JOB RESPONSIBILITIES

Strategic Management

· Develops strategic plans that include leveraging technology to maximize efficiency and profitability.

• Develops and oversees multi-year strategic business plan for the unit.
• Provides reports to Senior Leadership on overall business performance and other deliverables.
• Responsible for the growth of the portfolio by identifying new business and cross-selling opportunities.
• Obtains and optimizes the use of market intelligence, developing and launching suitable products and services, and cultivating a leadership role in the local industry.
• Recognizes business opportunities and threats and plans to accommodate them through long- and medium-term business development while keeping current with market trends through continuous study.
• Spearheads changes to existing protocols and policies across all levels of the organization to create a culture of excellence and profitable growth.

Financial Management

• Drive pricing strategies ensuring competitiveness and profitability.
• Monitor and manage the health loss ratio to ensure it remains within the set risk tolerance thresholds.
• Develop and manage the annual budget for the health unit.
• Monitor performance against budget, analyze variances, and provide actionable insights to senior leadership and the Board.
• Collaborate with the CFO on the health claims reserving (IBNR) and ensure adequate provisioning.
• Oversee the monthly renewals, monitor renewal retention rates and assess the financial impact of lapses, cancellations or lost accounts.
• Manage reinsurance programs related to health lines.
• Oversee health receivable management.
• Oversee claims recoveries from reinsurers.
• Support internal and external audits in relation to the health unit.

Underwriting

• Oversees the Underwriting team by providing direction and guidance on applications and establishing protocols.
• Oversees the development of new methodologies and models to assess the financial risk of the portfolio.

Claims Management

• Establishes a Claims Processing workflow that delivers acceptable levels of accuracy and timeliness.
• Manages the Claims Loss ratio and reports on trends.
• Ensures the efficiency of processing to meet all regulatory requirements.

Relationship Management

• Develops and maintains excellent relationships with the leadership team, business partners and other stakeholders, and staff.
• Maintains direct client, broker, provider, and reinsurer relations.
• Holds quarterly meetings with the HIC and proactively communicate items for awareness.

Compliance

• Ensures compliance with all company protocols, policies, and regulatory requirements.
• Develops and maintains knowledge, awareness, and understanding of company policies and procedures, goals and objectives, key performance indicators (KPI’s), plans and strategies, and work process improvements.

Customer Service

• Directs client communication and interface, which includes proactive communication, handling complaints, audit responses, account issues, and IT issues.

• Establishes the goals and objectives, standards, policies and procedures to achieve high-quality customer service outcomes in accordance with the company’s strategic plan.
• Monitor and promote increased client satisfaction.

People Management

• Provide proactive feedback to direct reports and other team members concerning possible issues, risks or areas of improvement.
• Technically manages the division through continuous training and directions of underwriting, claims, customer service, broker support and provider relations, including sign-off on exceptional underwriting and claim decisions.
• Responsible for ensuring appropriate resourcing levels through workforce planning.
• Establish operational and financials KPIs at the core of the department's performance management.

• Degree in business, finance, insurance, or economics from a recognized college or university.
• One advanced professional designation in life or health insurance, such as the FLMI, CEBS, or HIA.
• Ten years’ experience at the management level in health insurance. Two years of exposure each in underwriting, claims, operations, and customer care, preferred.
• Excellent leadership skills.
• interpersonal skills at all levels, including with cross-functional teams.
• Excellent oral and written communication skills.
• Knowledge of and familiarity with health technology solutions.

Cayman First offers a competitive compensation package with eligibility for a discretionary bonus, subsidized health insurance for employees and dependents, preferred home and motor insurance, a great company culture and work life balance. Compensation will be commensurate with experience and qualifications.

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‘First’ is more than our name, it’s our nature. Cayman First is an industry-leading Property & Casualty and Health insurer, delivering best-in-class products and services to respond to the changing needs of individuals, households and businesses. Through our carefully selected network of agents and brokers, we provide protection for our customers today and prepare them for a brighter tomorrow. Cayman First maintains an A- (Excellent) financial strength rating from global credit rating agency AM Best.

PURPOSE OF JOB We are seeking an experienced and dynamic Vice President – Health Insurance to lead our health insurance portfolio. In this executive role, you will oversee the full spectrum of operations including strategy, marketing, underwriting, administration, customer service, claims management, and overall profitability driving growth and excellence across the business. JOB RESPONSIBILITIES Strategic Management · Develops strategic plans that include leveraging technology to maximize efficiency and profitability. Develops and oversees multi-year strategic business plan for the unit. Provides reports to Senior Leadership on overall business performance and other deliverables. Responsible for the growth of the portfolio by identifying new business and cross-selling opportunities. Obtains and optimizes the use of market intelligence, developing and launching suitable products and services, and cultivating a leadership role in the local industry. Recognizes business opportunities and threats and plans to accommodate them through long- and medium-term business development while keeping current with market trends through continuous study. Spearheads changes to existing protocols and policies across all levels of the organization to create a culture of excellence and profitable growth. Drive pricing strategies ensuring competitiveness and profitability. Monitor and manage the health loss ratio to ensure it remains within the set risk tolerance thresholds. Develop and manage the annual budget for the health unit. Monitor performance against budget, analyze variances, and provide actionable insights to senior leadership and the Board. Collaborate with the CFO on the health claims reserving (IBNR) and ensure adequate provisioning. Oversee the monthly renewals, monitor renewal retention rates and assess the financial impact of lapses, cancellations or lost accounts. Manage reinsurance programs related to health lines. Oversee health receivable management. Oversee claims recoveries from reinsurers. Support internal and external audits in relation to the health unit. Oversees the Underwriting team by providing direction and guidance on applications and establishing protocols. Oversees the development of new methodologies and models to assess the financial risk of the portfolio. Claims Management Establishes a Claims Processing workflow that delivers acceptable levels of accuracy and timeliness. Manages the Claims Loss ratio and reports on trends. Ensures the efficiency of processing to meet all regulatory requirements. Relationship Management Develops and maintains excellent relationships with the leadership team, business partners and other stakeholders, and staff. Maintains direct client, broker, provider, and reinsurer relations. Holds quarterly meetings with the HIC and proactively communicate items for awareness. Compliance Ensures compliance with all company protocols, policies, and regulatory requirements. Develops and maintains knowledge, awareness, and understanding of company policies and procedures, goals and objectives, key performance indicators (KPI’s), plans and strategies, and work process improvements. Customer Service Directs client communication and interface, which includes proactive communication, handling complaints, audit responses, account issues, and IT issues. Establishes the goals and objectives, standards, policies and procedures to achieve high-quality customer service outcomes in accordance with the company’s strategic plan. Monitor and promote increased client satisfaction. People Management Provide proactive feedback to direct reports and other team members concerning possible issues, risks or areas of improvement. Technically manages the division through continuous training and directions of underwriting, claims, customer service, broker support and provider relations, including sign-off on exceptional underwriting and claim decisions. Responsible for ensuring appropriate resourcing levels through workforce planning. Establish operational and financials KPIs at the core of the department's performance management. Requirements

Degree in business, finance, insurance, or economics from a recognized college or university. One advanced professional designation in life or health insurance, such as the FLMI, CEBS, or HIA. Ten years’ experience at the management level in health insurance. Two years of exposure each in underwriting, claims, operations, and customer care, preferred. Excellent leadership skills. interpersonal skills at all levels, including with cross-functional teams. Excellent oral and written communication skills. Knowledge of and familiarity with health technology solutions. Cayman First offers a competitive compensation package with eligibility for a discretionary bonus, subsidized health insurance for employees and dependents, preferred home and motor insurance, a great company culture and work life balance. Compensation will be commensurate with experience and qualifications.

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ABOUT US ‘First’ is more than our name, it’s our nature. Cayman First is an industry-leading Property & Casualty and Health insurer, delivering best-in-class products and services to respond to the changing needs of individuals, households and businesses. Through our carefully selected network of agents and brokers, we provide protection for our customers today and prepare them for a brighter tomorrow. Cayman First maintains an A- (Excellent) financial strength rating from global credit rating agency AM Best.

PURPOSE OF JOB We are seeking an experienced and dynamic Vice President – Health Insurance to lead our health insurance portfolio. In this executive role, you will oversee the full spectrum of operations including strategy, marketing, underwriting, administration, customer service, claims management, and overall profitability driving growth and excellence across the business. JOB RESPONSIBILITIES Strategic Management · Develops strategic plans that include leveraging technology to maximize efficiency and profitability. Develops and oversees multi-year strategic business plan for the unit. Provides reports to Senior Leadership on overall business performance and other deliverables. Responsible for the growth of the portfolio by identifying new business and cross-selling opportunities. Obtains and optimizes the use of market intelligence, developing and launching suitable products and services, and cultivating a leadership role in the local industry. Recognizes business opportunities and threats and plans to accommodate them through long- and medium-term business development while keeping current with market trends through continuous study. Spearheads changes to existing protocols and policies across all levels of the organization to create a culture of excellence and profitable growth. Financial Management Drive pricing strategies ensuring competitiveness and profitability. Monitor and manage the health loss ratio to ensure it remains within the set risk tolerance thresholds. Develop and manage the annual budget for the health unit. Monitor performance against budget, analyze variances, and provide actionable insights to senior leadership and the Board. Collaborate with the CFO on the health claims reserving (IBNR) and ensure adequate provisioning. Oversee the monthly renewals, monitor renewal retention rates and assess the financial impact of lapses, cancellations or lost accounts. Manage reinsurance programs related to health lines. Oversee health receivable management. Oversee claims recoveries from reinsurers. Support internal and external audits in relation to the health unit. Underwriting Oversees the Underwriting team by providing direction and guidance on applications and establishing protocols. Oversees the development of new methodologies and models to assess the financial risk of the portfolio. Claims Management Establishes a Claims Processing workflow that delivers acceptable levels of accuracy and timeliness. Manages the Claims Loss ratio and reports on trends. Ensures the efficiency of processing to meet all regulatory requirements. Relationship Management Develops and maintains excellent relationships with the leadership team, business partners and other stakeholders, and staff. Maintains direct client, broker, provider, and reinsurer relations. Holds quarterly meetings with the HIC and proactively communicate items for awareness. Compliance Ensures compliance with all company protocols, policies, and regulatory requirements. Develops and maintains knowledge, awareness, and understanding of company policies and procedures, goals and objectives, key performance indicators (KPI’s), plans and strategies, and work process improvements. Customer Service Directs client communication and interface, which includes proactive communication, handling complaints, audit responses, account issues, and IT issues. Establishes the goals and objectives, standards, policies and procedures to achieve high-quality customer service outcomes in accordance with the company’s strategic plan. Monitor and promote increased client satisfaction. People Management Provide proactive feedback to direct reports and other team members concerning possible issues, risks or areas of improvement. Technically manages the division through continuous training and directions of underwriting, claims, customer service, broker support and provider relations, including sign-off on exceptional underwriting and claim decisions. Responsible for ensuring appropriate resourcing levels through workforce planning. Establish operational and financials KPIs at the core of the department's performance management. Degree in business, finance, insurance, or economics from a recognized college or university. One advanced professional designation in life or health insurance, such as the FLMI, CEBS, or HIA. Ten years’ experience at the management level in health insurance. Two years of exposure each in underwriting, claims, operations, and customer care, preferred. Excellent leadership skills. interpersonal skills at all levels, including with cross-functional teams. Excellent oral and written communication skills. Knowledge of and familiarity with health technology solutions. Cayman First offers a competitive compensation package with eligibility for a discretionary bonus, subsidized health insurance for employees and dependents, preferred home and motor insurance, a great company culture and work life balance. Compensation will be commensurate with experience and qualifications.

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**Role: Process Executive -** **Pre-Authorization - Health Insurance**
**Location: KL, Malaysia**
**Experience: 0-4 Years**
**Job Responsibilities and Expectations:**
· Review and validate pre-authorization requests for medical services and procedures.
· Ensure completeness of documentation submitted by policyholders and healthcare providers.
· Verify eligibility and coverage based on policy terms and conditions.
· Coordinate with internal claims and underwriting teams for complex cases.
· Input and update pre-authorization decisions in the claims management system.
· Communicate authorization outcomes to providers and insured members.
· Ensure compliance with Insurance Authority (IA) regulations and internal SOPs.
· Identify and escalate potential fraud or abuse cases to the compliance team.
· Maintain turnaround time (TAT) and service level agreements (SLAs).
· Support audits and quality checks by providing accurate documentation.
· Participate in training sessions to stay updated on regulatory changes.
· Handle sensitive medical information with strict confidentiality.
· Service and resolve inquiries from customers, members, beneficiaries, and others regarding Health Care products and benefits across multiple product lines
· Ability to communicate effectively across multiple channels, including phone, e-mail, chat, and text
· Ability to succinctly collect information from a customer to set up a new claim
· Ability to gather information from multiple source systems to understand and articulate the claim - and what information may be needed, next steps in processing, etc.
**Academic and Additional Qualifications Needed:**
· Bachelor's degree in Nursing, Health Sciences, Insurance, or related field.
· Basic understanding of medical terminology and health insurance policies.
· Proficiency in Cantonese, Mandarin, and English (speak, read, and write).
· Familiarity with Hong Kong's healthcare system and insurance regulations.
· Strong attention to detail and data entry accuracy.
**About Cognizant:**
Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant.
#LI-CTSAPAC
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

**Role: Delivery Lead - Business Operations (Health Insurance)**
**Location: KL, Malaysia**
**Summary:**
A Healthcare Insurance Delivery Lead is responsible for overseeing the successful delivery of projects and services within the healthcare insurance domain, ensuring client satisfaction and operational efficiency. This role involves managing teams, coordinating with various stakeholders, and implementing strategies to optimize delivery processes. The Delivery Lead also focuses on maintaining strong client relationships and driving continuous improvement initiatives.
**Required skills:**
+ Deep understanding of the **healthcare insurance industry** , including relevant regulations, compliance requirements, and market trends. (APAC market is preferred)
+ Language Proficiency in **English and Cantonese.**
+ End to end understanding of **health insurance claims process, benefits/policy servicing** , provider relationship and customer contact center
**Roles & Responsibilities:**
+ Oversee the planning, execution, and delivery of multiple projects simultaneously, managing scope, timelines, budgets, and quality parameters
+ Lead and manage project teams, fostering collaboration, communication, and professional development.
+ Act as a primary point of contact for clients, building and maintaining strong relationships, understanding their needs, and ensuring their satisfaction.
+ Implement and enforce quality assurance measures to ensure high-quality deliverables and adherence to service level agreements (SLAs).
+ Drive continuous improvement initiatives and process optimization to enhance efficiency and effectiveness.
+ Develop and implement strategies to optimize delivery processes, improve efficiency, and drive business growth within the insurance vertical.
Ensure projects are delivered within budget and maximize revenue and margins.
**About Cognizant:**
Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant.
#LI-CTSAPAC
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

Senior Business Analyst - Health Insurance (Fully Remote) Senior Business Analyst - Health Insurance (Fully Remote)

• Working on the latest tech for the Insurtech Market Leader
  
  

Top 3 Reasons To Join Us

• Competitive Salary
• 100% Remote
• Working on the latest tech for the Insurtech Market Leader
  
  

About Us

At CoverGo, our mission is to empower all insurance companies to make insurance 100% digital and accessible to everyone.

• We are a leading global no-code insurance platform for health, life, and P&C
• We're the winner of the Insurtech of the Year in all of Asia and other awards globally
• We work with insurance enterprise clients such as AXA, Bupa, MSIG, Dai-ichi, Bank of China Group Insurance, and many more
• We're an international, diverse team of over 120 people with 30 nationalities and team members working remotely from all over the world
• We are fully funded and backed by reputable VC funds and strategic institutional investors
• We have a global presence in Asia, EMEA and the Americas
• We've grown our annualized revenue by over 30x since January 2021
• We're constantly working towards making CoverGo a workplace that you love coming to. We deeply believe that bringing together a diversity of thoughts, expressions, and perspectives is key to building the best culture for equally diverse communities all over the world
  
  

What You Will Do:

• Work with clients and technical resources to identify their business problems and develop the right approach and analytical solution
• Plan and design simple to semi-complex business processes and system modifications
• Make recommendations to improve and support business activities
• Gather business requirements through a variety of techniques such as work sessions and interviews then analyze and document client complex business requirements and processes; communicate these requirements to appropriate parties
• Create complex test case scenarios to be used in testing; monitor/oversee the testing of business applications to verify that all client requirements are incorporated into the system design
• Develop business requirements documents/user stories to support the required modifications
• May plan, allocate and monitor work of other business analysts
• Understand simple to complex systems and related data to surface actionable insights, demonstrate sound judgment and decision-making skills
• Assist in providing time estimates for project related tasks
• Aid in updating process and procedural documentation
• Develop basic understanding of technical development cycle of mobile application or web portals
• Support QA, UAT and Release phases of the project via defect analysis, change maintenance, etc
• Any other task that may be assigned
  
  

What We Need:

• Minimum 5 years of experience as Business Analyst
• A degree in Business, IT or any relevant field
• Previous experience working in the health insurance industry is required (Insurtech or health insurance experience)
• Health Insurance-related domain certification from INS/LOMA or III is an added advantage
• Knowledge of business analysis concepts of defining requirements, translating to technical solutions, and Agile approach to prioritizing work to epics, sprints
• Business analysis skills including facilitation, process documentation, requirements gathering and user acceptance testing
• Good organizational/time management skills to prioritize work and meet deadlines within defined timeframes
• Experience in an Agile and/or Scrum environment is a must
• Basic knowledge in generating process documentation, and document system functionality, data integration, and workflow
• Excellent written and verbal communication skills in English
• Technical writing skills are a plus
• Must be based in Singapore or Malaysia
  
  

Why You'll Love Working Here

• Fully Remote
• Flexible Leave
• International Environment
• Competitive renumeration package
• Performance Bonus
• Stock Options after 6 months
• Company activities and events
• Learning and development plan
• Remote work allowance
  
  

CoverGo Company Video

By submitting your application, you confirm that you have read, understood, and accepted the content of CoverGo's Privacy Notice and you consent to the processing of your data as part of this application.Seniority level

• Seniority level Mid-Senior level

Employment type

• Employment type Full-time

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• Job function Analyst
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Quality Reviewer (Medical Pre-Underwriting - Health Insurance)

Join to apply for the Quality Reviewer (Medical Pre-Underwriting - Health Insurance) role at Cognizant

Quality Reviewer (Medical Pre-Underwriting - Health Insurance)

Join to apply for the Quality Reviewer (Medical Pre-Underwriting - Health Insurance) role at Cognizant

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Job Title: Quality Reviewer (Medical Pre-Underwriting - Health Insurance)

Job Location: Malaysia

Job Responsibilities And Expectations

• Conduct quality audits of underwriting decisions made by processors.
• Ensure adherence to underwriting guidelines and regulatory standards.
• Identify trends in processing errors and recommend corrective actions.
• Collaborate with training teams to address knowledge gaps.
• Review escalated cases for accuracy and completeness.
• Maintain audit logs and prepare quality reports for management.
• Ensure compliance with IA regulations and internal audit protocols.
• Assist in updating standard operating procedures based on audit findings.
• Support continuous improvement initiatives in underwriting workflows.
• Provide feedback to processors to enhance accuracy and efficiency.
• Participate in system testing for underwriting rule updates.
• Ensure confidentiality and integrity of medical data during reviews.
  
  

Academic And Additional Qualifications Needed

• Bachelor’s degree in Life Sciences, Nursing, Healthcare Administration, or related field.
• 3–5 years of experience in health insurance underwriting or quality assurance.
• Strong knowledge of Hong Kong’s health insurance regulatory framework.
• Fluency in Cantonese, Mandarin, and English (speak, read, and write).
  
  

About Cognizant

Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant.

Seniority level

• Seniority level Mid-Senior level

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• Job function Administrative
• Industries IT Services and IT Consulting and Business Consulting and Services

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**Role: Process Executive - BD Direct Support - Health Insurance**
**Location: KL, Malaysia**
**Experience: 0-4 Years**
**Job Responsibilities and Expectations:**
**-** Assist in onboarding new individual and corporate clients by collecting and verifying documentation.
- Support the BD team in preparing customized health insurance proposals and quotations.
- Maintain accurate records of client interactions and proposal submissions.
- Coordinate with underwriting and policy servicing teams to ensure timely processing of new applications.
- Respond to basic client queries related to product features, benefits, and application status.
- Ensure compliance with Insurance Authority (IA) guidelines during client interactions.
- Assist in scheduling meetings and presentations for BD executives.
- Generate reports on lead conversion and client engagement metrics.
- Support digital onboarding and CRM data entry processes.
- Collaborate with marketing teams to distribute promotional materials and campaigns **.**
**Academic and Additional Qualifications Needed:**
**-** Bachelor's degree in Business Administration, Insurance, or related field.
- Basic understanding of health insurance products and services.
- Proficiency in CRM systems and Microsoft Office tools.
- Strong communication and organizational skills.
- Fluency in Cantonese, Mandarin, and English (speak, read, and write).
**About Cognizant:**
Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant.
#LI-CTSAPAC
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

**Job Title:** Quality Reviewer (Medical Pre-Underwriting - Health Insurance)
**Job Location:** Malaysia
**Job Responsibilities and Expectations**
+ Conduct quality audits of underwriting decisions made by processors.
+ Ensure adherence to underwriting guidelines and regulatory standards.
+ Identify trends in processing errors and recommend corrective actions.
+ Collaborate with training teams to address knowledge gaps.
+ Review escalated cases for accuracy and completeness.
+ Maintain audit logs and prepare quality reports for management.
+ Ensure compliance with IA regulations and internal audit protocols.
+ Assist in updating standard operating procedures based on audit findings.
+ Support continuous improvement initiatives in underwriting workflows.
+ Provide feedback to processors to enhance accuracy and efficiency.
+ Participate in system testing for underwriting rule updates.
+ Ensure confidentiality and integrity of medical data during reviews.
**Academic and Additional Qualifications Needed**
+ Bachelor's degree in Life Sciences, Nursing, Healthcare Administration, or related field.
+ 3-5 years of experience in health insurance underwriting or quality assurance.
+ Strong knowledge of Hong Kong's health insurance regulatory framework.
+ Fluency in **Cantonese, Mandarin, and English (speak, read, and write)** .
**About Cognizant** **:**
Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at or @cognizant .
**#LI-CTSAPAC**
Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.