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Generative AI Development in the Health Insurance Sector: HiMi Case Manager, Appeals Manager Care
Project duration: 1 year
Brief description
In collaboration with the various departments, new AI solutions are being developed to further improve the health insurance company´s core business and the care provided to its members through data-driven insights.
Supplement
In addition to forecasting models that rely on traditional statistical learning methods, solutions using generative AI techniques-and large language models in particular-are increasingly being deployed. The applications are all developed as client-server web applications and access external AI interfaces. We manage the entire lifecycle of the AI applications, including deployment and production operations.
Subject description
The Assistive Devices Case Manager (HiMi) is designed to simplify the assessment of complex assistive device applications for case workers, thereby saving time and reducing the workload associated with evaluating and managing HiMi cases. To this end, data regarding relevant aspects (medication history, hospitalization history, etc.) is consolidated with the application information contained in the case file. The Appeals Manager generates summaries of the case file and case history for appeals related to care level applications, enabling case workers and the appeals committee to save time when evaluating the appeals.
IT project data
- Industries Statutory health insurance
- Specialist tasks statutory health insurance
- DP tasks customised software new development
- System environments Client/Server
- Procedure model Scrum
- Programming languages Python
- Development and test tool GitLab, Jupyter Notebook
- Standard software and BI JIRA
- System software Confluence
- Middleware and frameworks Apache Kafka, SOAP
Project period01.01.2026 - 31.12.2026
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