• Responsible for insurance fraud detection and investigation services to reduce fraud-related claim payments and costs, while avoiding unwarranted risk. • Ensure compliance with laws and regulations relating to claims handling and unfair claims practices and reporting statutes. • Participates in the establishment and implementation of policies and procedures for fraud control and investigative practices. • Performs leadership and management tasks, i.e., providing coaching, evaluating performance, review of time sheets, managing time off, conducting quarterly check-ins/ride-alongs, etc. • Evaluates, authorizes, and implements actions and decisions to carry out proactive claim's projects and investigations. • Review and evaluate investigation recommendations from investigators to ensure results and case documentation support conclusions. • Ensure risks associated with business activities are effectively identified, measured, monitored, and controlled in accordance with risk and compliance policies and procedures.

• Assesses member's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to member's needs and aligned with the benefit structure. • Facilitates response to gaps in care and identified high risk members to appropriate settings of care for annual wellness visits including collaboration with treating provider. • Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided for both acute and chronic health care needs. • Develops, coordinates and assists in implementation of individualized plan of care for members and identification of barriers towards Self-Management and optimal wellness. • Coordinates with members, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. • Monitors member's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. • Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. • Encourages member participation and compliance in the case/disease management program efforts.

Role Description Join us as a Senior Data Delivery Manager and become the trusted Engagement Lead for enterprise-scale data and AI programs. You'll steer engagements that modernize data estates, activate analytics, and embed AI—from the first strategic conversation through delivery and continuous value realization. Acting as the connective tissue between Sales, Delivery, Solution Architects, and client stakeholders, you'll ensure data-led commitments translate into measurable outcomes and long-term partnerships. - Own end-to-end data engagements—from opportunity qualification and innovation workshops through solution shape, delivery, stabilization, and account expansion. - Become a strategic data advisor to executive sponsors, business owners, IT leaders, and Chief Data/Analytics Officers across our global enterprise client base (Europe, the Americas, LATAM, APAC). - Lead client communication and governance: set cadence, run steering committees, negotiate scope, manage expectations, and resolve escalations. - Drive business value in initiatives such as data platform and Lakehouse buildouts, enterprise data warehouse modernization, cross-platform data migrations, advanced analytics, ML/AI activation, and data governance transformations. - Frame target-state data visions with clients—connect business priorities to data strategy, operating models, KPIs, and transformation roadmaps. - Partner with Sales and Solution Architects during presales to shape delivery models, define data capabilities, and architect scalable approaches for complex data ecosystems. - Ensure seamless deal-to-delivery transitions, with clarity on scope, governance, team structure, and execution plans grounded in data operating best practices. - Validate SOWs and commercials to ensure feasibility, profitability, and alignment with client data goals. - Coordinate multiple delivery streams across data engineers, data scientists, analytics specialists, data architects, product owners, and fellow Delivery Managers—with support for both mature data organizations and greenfield team buildouts. - Establish and run delivery governance with data-centric KPIs, risk frameworks, quality gates, and escalation paths—with best practices applied across modern cloud and analytics ecosystems. - Spot and cultivate growth opportunities through recommendations on data capability roadmaps, platform optimizations, and AI/analytics extensions. - Contribute to account strategy and presales, mentor junior Delivery Managers, and foster a consultative, data-first culture focused on business outcomes. Qualifications - 8+ years of experience in IT services, consulting, or digital delivery with a sustained focus on data platforms, analytics, AI/ML, data migration, or data governance programs. - Proven ability to lead multi-stream data engagements for enterprise clients, with orchestration of cross-functional and globally distributed teams. - Demonstrated success in data-focused presales and solution shape, with alignment of business value, data strategy, and delivery economics. - Excellent stakeholder management, communication, negotiation, and escalation skills in English (B2+ required); additional languages are a plus. - Systems-thinking mindset with the ability to connect sales, delivery, operations, and data value realization. - Strong understanding of data architecture patterns, governance, quality, privacy/compliance, and how they translate into delivery plans and operating models. - Experience to translate data strategy into actionable roadmaps, KPIs, and execution plans while balancing stakeholder priorities. - Working knowledge of modern data platforms and toolchains (e.g., Azure/AWS/GCP analytics services, Databricks, Snowflake, Power BI/Tableau, dbt, MLOps practices)—sufficient to challenge assumptions, guide conversations, and support technical teams.

Role Description Du möchtest mehr als nur Zahlen verwalten? Bei Pathé spielst du eine wichtige Rolle in unserem Finance Team. Du lernst von erfahrenen Kolleginnen und Kollegen, arbeitest mit modernen Tools und gestaltest Prozesse mit. Wir bieten dir ein dynamisches Umfeld mit kurzen Entscheidungswegen, flexiblen Arbeitsbedingungen und klarer Einarbeitung. Qualifications - Abgeschlossene KV-Ausbildung mit Weiterbildung im Bereich Finanz- und Rechnungswesen (Eidg. FA) - Min. 4 Jahre Erfahrung im Bereich Finanzbuchhaltung inkl. Führungserfahrung - Gute MS-Office-Kenntnisse - Erfahrung mit Abacus und/oder Microsoft Dynamics von Vorteil - Deutsch als Muttersprache, Englisch B2/C1 erforderlich Requirements - Debitorenmanagement inkl. Mahnwesen - Kreditorenmanagement inkl. Zahlungswesen - Kontrolle der täglichen Einnahmen und deren Verbuchung - Cash-Management - Buchführung der allgemeinen Buchhaltung - Führen und Überwachen der Anlagebuchhaltung - Periodische Abschlüsse (Monat, Semester, Jahr), allgemeines Reporting - Intercompany-Abstimmungen und Verrechnungen - Administrative Arbeiten und gesetzlich vorgeschriebene Abrechnungen (MWSt/Steuern) Benefits - Praxisnahes Onboarding mit klarer Begleitung und regelmässigem Feedback. - Moderne Arbeitsmittel und flexible Arbeitsbedingungen. - Ein kollegiales Team und kurze Entscheidungswege. - Entwicklungsmöglichkeiten im Finance-Bereich. Skills - Buchhaltung - Belastbarkeit - Organisation - Management - Teamwork - Zahlenaffinität