Control Doctor - SZV

Organization

SZV is responsible for the administrative and financial management of the social and health insurances of Sint Maarten. Providing access to a variety of medical insurance benefits, pension allowances, loss of wages for employers and ensuring compliance in premium collection.
As a people-centered and innovation-driven organization, our dynamic team works closely with government, healthcare, and community partners to support the sustainable development of Sint Maarten.

Role
As a Control Doctor, you play a vital role within the Sick Leave and Medical Authorization Department, responsible for executing medical tasks according to the ‘Landsverordening Ziekte- en Ongevallenverzekering’ regulation. This position reports directly to the Sick Leave and Medical Authorization Manager.
The Control Doctor monitors SZV-insured individuals for work disability (arbeidsongeschiktheid), oversees medical referrals abroad, and provides expert advice on medical matters related to social insurance policies, particularly medical expenses.
Your key duties and responsibilities include:

• Assessing and monitoring SZV-insured individuals for illness, disability, treatment progress, and work capability.
• Advising employers on employee work ability and reviewing disability days.
• Determining industrial accidents and assessing permanent disability rates.
• Reviewing and approving authorization requests for medical expenses, specialist treatments, and paramedical care.
• Evaluating and approving medications for SZV reimbursement based on established guidelines.
• Processing medical expense claims for local and overseas treatments, including approving foreign medical referrals when specialized care is unavailable locally.
• Providing on-call medical assistance during scheduled shifts, including holidays, vacations, and on emergency cases.
• Liaising with healthcare providers, general practitioners, and medical institutions on behalf of patients.
• Supporting cost-control efforts, legal proceedings, and health education initiatives in collaboration with relevant departments.
• Ensuring compliance with SZV’s medical policies and contributing to continuous improvements in patient care and medical assessment procedures.

Profile

• A degree in Medicine, preferably with a specialization in insurance or occupational medicine.
• A valid BIG registration is a plus.
• Excellent verbal and written communication skills in English and Dutch.
  

Procedure
Interested candidates can submit their motivation letter and CV by clicking on the apply button (sollicitatieknop) below. For any questions, please contact Mr. Daniel Jansen at jansen@balancecaribbean.com.