About the Role
Responsible for overseeing all aspects of customer management and insurance operations, including underwriting, policy servicing, customer service, claims management, and reinsurance. With a strong focus on health insurance and digital distribution, the CCOO ensures operational excellence, superior customer experience, and effective risk management. The role drives process efficiency, operational scalability, and customer-centric innovation to support business growth and profitability.
Responsibilities
Underwriting & Risk Assessment:
- Oversee underwriting operations to ensure accurate risk assessment, pricing, and portfolio profitability.
- Develop underwriting policies, guidelines, and automated tools for efficient decision-making.
Policy Administration & Customer Service:
- Ensure timely and accurate issuance, maintenance, and servicing of insurance policies.
- Drive high-quality customer service across all touchpoints, leveraging digital platforms for seamless customer experience.
Claims Management:
- Lead claims operations to ensure fair, efficient, and timely claims settlement.
- Implement processes to minimize fraudulent claims and optimize claims cost management.
Customer Experience Leadership:
- Design and implement a customer-centric operational model covering the full medical and insurance journey from onboarding to claims and post-service engagement.
Claims and Case Management Excellence:
- Oversee the development and continuous improvement of claims, case, and care management frameworks to ensure fairness, accuracy, and speed.
- Establish data-driven monitoring and predictive tools to manage high-cost claims and optimize medical cost containment.
Provider and Hospital Network Management:
- Develop and maintain strategic partnerships with hospitals, clinics, and health service providers nationwide to ensure quality, efficiency, and accessibility.
- Negotiate and manage provider contracts and pricing frameworks to control loss ratios while maintaining service quality.
Fraud, Waste, and Abuse (FWA) Control:
- Implement robust fraud detection and prevention systems using analytics, AI, and machine learning to identify anomalies and ensure claim integrity.
- Lead investigations and collaborate with compliance and legal teams on fraud management protocols.
Digital Transformation and Process Optimization:
- Drive automation, self-service, and digital tools to enhance customer experience and operational efficiency.
Reinsurance Management:
- Oversee reinsurance strategies and treaties to optimize risk transfer and protect the company's solvency.
- Ensure compliance with regulatory requirements and effective monitoring of reinsurance partners.
Operational Excellence & Digital Enablement:
- Streamline and standardize processes across underwriting, policy service, claims, and reinsurance.
- Drive digital adoption and process automation to enhance operational efficiency and customer experience.
Leadership & Collaboration:
- Lead, mentor, and develop high-performing operations teams.
- Collaborate with peers in Distribution, Marketing, Finance, and Corporate Affairs to align operations with business strategy.
Qualifications
- Education: Bachelor's degree in Insurance, Business Administration, Finance, or related fields.
- Advanced degree or professional certifications (ACII, CPCU) preferred.
- Minimum 15 years in health insurance operations or healthcare management, with at least 5 years in a senior leadership role at a leading insurer (AXA, Allianz, or equivalent).
- Deep understanding of medical networks, health claims management, cost containment, and customer service transformation.
- Proven track record in building provider partnerships, optimizing operational efficiency, and driving digital health transformation.
- Proven experience leading large operational teams and implementing process improvements or digital initiatives.
- Knowledge of digital distribution channels and customer-centric operations highly desirable.
- Strong leadership, creativity, and stakeholder management skills.
- Excellent English and Vietnamese communication skills (both written and spoken).
