Наталія

Nataliia Borozenets
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Personal Profile Statement
I have a university degree in medical care, a second university degree in healthcare management and a bachelor's degree in business economics. For the past 11 years, I have been managing a medical assistance service in an insurance company. During this period, I have experience in launching projects, developing, implementing and refining software, working closely with medical institutions and recruiting staff.
I also managed an information and analytical center for medical statistics at outpatient clinic. During this period, I have experience in implementing new software and automating the process, consolidating statistical data from various medical institutions within the structure of the State Administration of Affairs and analyzing them. I also have clinical experience as a haematologist.
Achievements
• high level of customer NPS (87 – 92%);
• uninterrupted operation of the assistance service since the first days of the war, including periods of power outages;
• Excellent organizational, comminication and analytical skills
Education
1. 2008 - 2010 - National University of Pharmacy, Faculty of Economics and Management, Kharkiv.
Qualification: Bachelor's degree in Business Economics.
2. 2003 - 2005 - Kharkiv Medical Academy of Postgraduate Education, Management, speciality Healthcare Management, Kharkiv.
Qualification: Healthcare manager.
3. 1993 – 1999 - National Medical University, specialty General Medicine, Kyiv.
4. 1999 – 2003 - Kyiv Medical School No. 2, specialty nurse, Kyiv.

Employment
Head of the Medical Assistance and Claims Settlement Department of Garant-Assistance LLC (February 2013 - April 2024)
• organisation of medical assistance work;
• recruitment and training of staff;
• preparation of regulatory documentation;
• underwriting of medical insurance programmes;
• operational control of the call-center staff effectiveness;
• control of the quality and scope of medical services provided;
• development and implementation of a system of staff motivation and demotivation;
• control and coordination of work with insurance companies;
• development of insurance programmes in accordance with the protocols of medical care of the Ministry of Health of Ukraine;
• development and underwriting of insurance contracts and programmes for insured persons;
• control over the conduct of examinations under voluntary health insurance and civil liability contracts;
• conducting expert examinations of disputed cases and reviewing complaints from insured persons;
• work with accounts receivable;
• preparation of tender documentation;
• correspondence and negotiations with foreign partners;
• preparation of reports, translation of documents;
• negotiating with healthcare institutions to conclude contracts for the provision of medical services under voluntary health insurance programmes;
• development and implementation of new service in medical assistance;
• development and implementation of a new database for the assistance service;
• work on budgeting of the department.

Expert assessment specialist at the Medical Assistance and Claims Settlement Department of Garant-Assistance LLC (March 2012 - February 2013)
• analysis of payments under medical insurance contracts;
• examination of invoices from medical institutions;
• drafting claims and correspondence with legal entities;
• conducting fraud investigations;
• examination of medical documents;
• control over the use of limits under insurance programmes;
• control of compliance with the terms of medical insurance contracts;
• control of the quality and scope of medical services provided;
• acceptance of claims from the Insured Persons regarding the quality and scope of medical care;
• preparation of reports on the work of the assistance and their analysis.

Leading expert of the medical insurance claims settlement and examination department of JSC Alfa Insurance (2011 - February 2012)
• analysis of payments under medical insurance contracts;
• coordination of coverage under insurance programmes with assisting companies;
• examination of invoices from medical institutions;
• examination of documents from individuals;
• control over the use of limits under insurance programmes;
• examination of invoices from assisting companies;
• conclusion of contracts with medical institutions;
• control of compliance with the terms of the medical insurance agreement;
• control of the quality and volume of medical services provided;
• accepting claims from the Insured regarding the quality and scope of medical care.

2008 - 2011 - State Institution "Clinical Polyclinic No. 1" of the State Administration of Affairs as Head of the Information and Analytical Department of Medical Statistics
• administrative and organisational work of the polyclinic;
• reporting on the work of the polyclinic;
• analysis of activities, preparation of analytical tables, materials;
• preparation of regulatory documents;
• compilation and design of analytical reference books;
• coordination and interaction between structural units of the polyclinic;
• implementation of an information and analytical database;
• consolidation of reports of all medical institutions of the Department and submission of data to the city statistics centre.

2007 - 2008 - State Institution "Clinical Polyclinic No. 1" State Administration of Affairs as a doctor-statistician.
• maintaining current statistical documentation;
• preparation of reports on the work of the clinic;
• preparation of analytical tables and calculation of statistical performance indicators.

Research associate at the Institute of Haematology and Transfusiology of the Academy of Medical Sciences of Ukraine
(2000 - 2007)
• research work;
• writing and translation of scientific publications;
• treatment of patients.

Laboratory doctor (1999 – 2000)
• treatment of patients;
• taking of material for scientific research;
• conducting scientific research;
• carrying out diagnostic and therapeutic manipulations

Qualification
1. 2023 The use of metaphorical association cards in dealing with crisis states of adults and children
2. 2020 Stanford Introduction to Food and Health
3. 2008, 3 months - National University of Healthcare of Ukraine, speciality courses in healthcare organization
4. 2001, 3 months - National University of Health of Ukraine, speciality courses in hematology
5. 2000, National University of Healthcare of Ukraine, speciality course in therapy.

Skills
1. Proficient user of Microsoft Word, Microsoft Excel, Access, PowerPoint;
2. Experience in working with and implementing databases on various platforms;
3. Driving licence;
4. Knowledge of languages
• Ukrainian - native language;
• Russian - fluent;
• English - B1 (B1 - spoken, extensive experience in translating English-language medical literature and documentation)