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The Director, Medical Officer is responsible for shaping the technical direction of underwriting and claims across Affluent and mass market segments. This role is pivotal in driving PAMB's transformation agenda-advancing digital and AI-enabled capabilities, and ensuring robust governance and service excellence to support the company's strategy and future-ready operating model.
The incumbent will collaborate with key stakeholders to drive continuous improvement, support product and campaign initiatives, and advance digital and AI-enabled capabilities that enhance efficiency, strengthen controls, improve decision quality, and elevate the overall customer and business experience.
1. Transformation, Automation and AI Excellence
- Provide visionary leadership to align underwriting and claims transformation with business objectives, regulatory requirements, and a culture of technical excellence.
- Champion the integration of advanced technology solutions-automation, AI, and analytics-to drive operational efficiency, superior decision quality, and enhanced customer experience.
- Direct the design and deployment of digital platforms and systems, streamlining processes, strengthening controls, and delivering measurable business outcomes.
- Oversee the implementation of automation and AI-enabled tools, consolidating Straight-Through Processing (STP) for clear accountability and optimized performance.
2. Affluent Underwriting Leadership
- Architect and lead the underwriting strategy for Affluent segments, ensuring alignment with risk appetite, regulatory standards, and service excellence.
- Build and mentor a high-performing team, setting technical standards and fostering innovation in digital underwriting solutions.
- Serve as the technical authority for complex Affluent cases, collaborating across business units to enable growth and differentiated customer value.
- Establish strategic partnerships with internal and external stakeholders to anticipate market trends, identify emerging risks, and proactively shape underwriting strategies.
3. Underwriting and Claims Technical Excellence
- Oversee the development and governance of underwriting and claims frameworks, guidelines, and quality standards for all business segments.
- Lead appeal management and engage with reinsurers on technical matters, product structures, and campaign initiatives.
- Strengthen governance for non-health claims (Personal Accident, Critical Illness, Total Permanent Disability, Death) and partner with Health and Claims teams to deliver seamless customer journeys.
- Manage relationships with key stakeholders (reinsurers, hospital networks, LIAM) to drive collaboration and continuous improvement.
- Develop and execute annual training roadmaps and specialized programs to sustain technical capability and professional standards.
- Ensure consistent application of guidelines and frameworks through robust training and governance.
4. Organizational Leadership & Change Management
- Drive the transition to a future-ready structure, including organizational redesign, new role creation, and consolidation of functions.
- Foster a culture of technical excellence, innovation, and continuous improvement across underwriting and claims.
- Provide strategic leadership and guidance during organizational change, ensuring alignment with business objectives and regulatory requirements.
Job Specification
- Medical Degree (MBBS or equivalent).
- At least 10 years insurance experience in underwriting and claims.
- Deep expertise in risk assessment, medical underwriting, and claims adjudication.
- Experience in risk management, new business underwriting, and portfolio management.
- Strong digital/technology skills (AI, analytics, automation).
- Excellent medical and insurance product knowledge.
- Strong communication, stakeholder management, and organizational skills.
- Adaptable, resilient, and able to manage competing priorities.
- High integrity and discretion with confidential information.
Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex, race, age, ethnic origin, educational, social and cultural background, marital status, pregnancy and maternity, religion or belief, disability or part-time / fixed-term work, or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade, job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
