Medical Information

2 months ago

جدة, Saudi Arabia Bupa Arabia Full time

Generate & maintain Bupa Arabia (BA) / Bupa CareConnect (BCC) clinical guidelines. Design & engineer up-to-date clinical care pathways and govern all value-based initiatives across BA & BCC. Contribute to the medical educational activities needed within BA/BCC to improve the clinical knowledge & policy interpretation across BA/BCC. Arbitrate & manage complex cases including regulatory complaints

Medical Guidelines development
- Conduct the required scintific research for all the required data in developing the medical guidelines for BA/BCC and have the right knowledge and skills to ensure obtaining the correct information.
- Maintain all the current guidelines up-to-date and generate a periodic new version to ensure the availability of the new version to all BA & BCC users.
- Ensure the validation of all newly published guidelines while securing their publication onto the appropriate data broadcasting platforms.
- Trace the international societies and medical journals for any new updates with regards to new clinical interventions.
- Keep track and report all validated and published guidelines

Population Health Management (PHM)
- Collaborate with the concerned departments to identify baseline measures of treatment costs and health status.
- Identify specific subgroups that are outliers on cost and outcome metrics and define changes to their care processes.
- Design clinical care pathways for the defined groups by conducting thorough literature review for the selected medical conditions.
- Articulate Medical Scripts to be used as tools of health promotion.
- Contribute in the development and governance of value based bundle models.
- Set clinical goals, monitor the health outcomes of designed programs, evaluate the impact of the clinical interventions, and make the necessary adjustments to optimize outcomes.
- Conduct the required training for all internal & external stakeholders upon the publication of each designed clinical pathway.
- Participate in national forums with regulators & NGOs to in relation to population health management initiatives.
- Collaborate with the proper teams to optimize system functionality in managing PHM.

Clinical Effectiveness
- Arbitrate the QDI forum in collaboration with TQM & other medical departments.
- Conduct regular Medical Educational Programs for BA/BCC (example: medical quiz).
- Monitor and report performance and outcome, while initiating the necessary intervention to optimize medical education.
- Collaborate with Training and Development to enhance the training modules for BA/BCC medical staff

Regulatory Management
- Lead regulatory requirements on behalf of BA/BCC.
- Assess escalated regulatory complaints by reviewing the given data, defining the exact concern, assessing the relevance & quality of the data, categorizing evidence according to the strength of recommendation & summarize evidence into a Rapid Response Guideline.
- Initiate internal discussions/meetings with relevant departments to discuss disputed cases.
- Formulate case studies that can be used for educational purposes in addition to regulatory discussions

Medical Decision making
- Lead the review of all medical enquiries & complex cases escalated to medical department.
- Track all cases adjudicated outside the documented guidelines as part of building BA/BCCs “Stare decisis”.
- Ensure adherence to all policy and medical rules in each decision making

**Skills**:

- Internal or Family Medicine board certified or Masters in population/ public health is preferred.
- Medical research.
- Population Health Management.
- Medical Education.
- Quality Management.
- Excellent communication skills, in both written & spoken English & Arabic

**Education**:
Medicine and Surgery

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