Control Doctor

We are seeking a detail-oriented and proficient Control Doctor to join our Sick Leave and Medical Authorization Department, which is responsible for executing medical tasks under the ‘Landsverordening Ziekte -en Ongevallenverzekering.’ The Control Doctor has the critical role of monitoring the SZV insured for work disability (AO), ensuring the approval of medical referrals abroad, and advising on medical matters within the social insurance policy, particularly medical expenses.  

The Control Doctor reports directly to the Sick Leave and Medical Authorization Manager.

Key Duties & Responsibilities:

1. Monitoring disability (AO)
   - Monitoring SZV-insured persons for illness, disability, and progress of treatments.
   - Performing medical monitoring and inspecting civil servants for capability, disability, illness, and treatment progress.
   - Advising employers on the work ability of their employees.
   - Reviewing and monitoring disability days.
   - Ensuring the recording of medical data and management of complete medical records
   - Determining industrial accidents.
   - Determining the degree of disability and permanent disability rate of the insured in cases of industrial accidents.
   - Providing authorization if specialist care is required.
   
   

2. Health Expenses
   - Reviewing and approving authorization requests.
   - Deciding on specialist examination and treatment and paramedical treatments.
   - Approving medications to be reimbursed by SZV based on established lists.
   - Examining, assessing, and deciding on the reimbursement of bills regarding treatments on Sint Maarten and abroad.
   
   

3. Medical Referrals
   - Referring patients abroad if specialist care is not offered locally.
   - Reviewing and approving foreign destinations for specialized treatments.
   
   

4. Emergency
   - Working on-call shifts according to the established schedule (including vacations and holidays).
   - Contacting the Governor's Office in cases of emergencies involving uninsured and/or illegal patients.
   
   

5. Other
   - Maintaining contact with general practitioners, medical institutions, and other health care providers on behalf of patients.
   - Achieving savings in benefit wage loss and medical facility expenses.
   - Informing and instructing policyholders by providing (health) education.
   - Conducting medical presentations for external interest groups in cooperation with the Customer Care & Communications Departments.
   - Preparing or advising in the preparation of appeals and petitions to the Board of Appeals and ‘Landsverordening Administratieve Rechtspraak (LAR)’ in cooperation with the Legal Department.
   - Following procedures and work agreements as applicable within the department.

Education & Experience:
- Valid Ministerial decree (BIG-registration/Uni-Code).
- Doctorate in Medicine, Insurance Doctor, and/or Occupational Doctor.
- Specialization training of at least two (2) years in insurance or occupational medicine.
- Minimum of two (2) years’ work experience as a Doctor.

Knowledge & Skills:
- Knowledge of the medical portion of health insurance coverage.
- Knowledge of occupational and insurance medicine.
- Knowledge of social legislation.
- Excellent verbal and written communication skills in English and Dutch.

Interested?

Send a written application with your CV and diplomas/certificates via email to hr@szv.sx by December 6, 2024 with the subject: Application – Control Doctor.
To inquire more information about the position, you may contact the Human Resources Department at hr@szv.sx. More information about SZV can be found at www.szv.sx.