Control Doctor

At SZV, we play a vital role in safeguarding the well-being of Sint Maarten by managing the social and health insurance benefits for our community. As part of our Sick Leave and Medical Authorization Department, you will help ensure fair, timely, and professional medical evaluations, supporting employees, employers, and their families when it matters most. We are looking for a Control Doctor to help us uphold our commitment to quality care, compliance, and the sustainable development of our island.

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

Key Duties & Responsibilities:

1. Monitoring disability (AO)
   - Monitoring SZV-insured individuals 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 and Corporate 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.
- Minimum two (2) years’ experience in insurance or occupational medicine.

Knowledge & Skills:
- Knowledge of health insurance coverage, social legislation, and medical protocols.
- Excellent verbal and written communication skills in English and Dutch.

Interested?

If you are committed to safeguarding quality care and ensuring fair, timely medical evaluations for our community, we invite you to apply!

Submit your written application with your CV and diplomas/certificates via email to the People & Culture Department at people-culture@szv.sx  with the subject: Application – Control Doctor. For more information about the position, you may also contact the department. 

To learn more about our organization, visit us at www.szv.sx.