Specialist Tariff Control and Economic Efficiency Audit – 100%

In our team for tariff control and combating insurance abuse, you analyze the behavior of service providers, identify irregularities in cost and benefit developments, and derive concrete measures from them. In doing so, you operate at the interface of tariff systems, benefit controlling, data analysis, and negotiations with service providers. Why? To recognize deviations, ensure compliance with the legal bases (KVG/VVG), and contribute to an efficient use of resources – while simultaneously maintaining constructive cooperation with service providers and partners.

What you achieve daily

• In your role as an analyst and tariff specialist, you collect and structure relevant data to create well-founded analyses. In doing so, you use the existing tools or specifically request additional information from the responsible specialist department. On this basis, you analyze the data using suitable key figures such as benchmarks, developments, or recognizable patterns and derive targeted controls from them. You then evaluate the results, prepare them in an understandable way, and formulate concrete recommendations for action.
• Furthermore, you take on a central coordination function: You communicate your analysis results internally, ensure their traceability, and accompany the implementation of defined measures in close cooperation with various areas – such as invoice control, negotiation teams, or when establishing internal work instructions. In addition, you actively participate in cross-departmental projects.
• In addition to this, you conduct negotiations with service providers, especially in the event of irregularities in billing. You steer the discussions with the goal of achieving reimbursements, adjustments to billing practices, or other suitable measures. If necessary, you work closely with the legal department, especially with regard to possible legal steps.

What you bring to the team

• You possess strong analytical skills and are confident in handling numbers and data. You analyze complex issues in a structured manner, prepare results understandably, and communicate them in a manner appropriate to the target audience. Independent working as well as a confident demeanor in discussions and negotiations are among your strengths.
• You have training in the field of health, social, or medical insurance or a comparable qualification and have several years of professional experience in the healthcare sector, ideally with a health insurer, a hospital, or a service provider.
• You have very good knowledge of Microsoft tools, especially Excel. Experience with Power BI or comparable analysis tools is an advantage.

You bring sound knowledge in at least one of the following specialist areas:

• Outpatient tariffs and tariff structures (especially TARDOC, TARMED, or comparable tariff systems)
• Inpatient services and hospital controlling (e.g., SwissDRG, inpatient invoice auditing, or benefit controlling)
• Data analysis and controlling (e.g., evaluation of large datasets, statistical analyses, or business intelligence solutions)

Your benefits:

• 40-hour week (at 100%)
• At least five weeks of vacation
• Possibility of working from home
• Monthly contribution to the costs of a public transport subscription for the commute
• Attractive social benefits and significantly discounted health insurance premiums
• Welcome Day and internal specialist training

Start date: Immediately or by arrangement
Employment degree: 100%

j4id10421536a j4it1040a j4iy26a