Medical Doctor

3 weeks ago


المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member's health & safety and aligned to BUPA Values.
You will be responsible for the following:

- Medial cost & Service Management: Adjudicate the cases (In-Patient & Out-Patient) based on common medical practice and in line with Bupa protocols and policy. Ensure the decisions are according to the best medical standards and agreement terms & conditions in order to prevent abuse, fraud and overtreatment.
- High quality medical decision & patient safety: Ensure working with high quality of decision making with Zero QDI (Quality Demerit Index) A or B. Ensure the medical decisions are consistent and are implemented based on clinical and practice guidelines signed off by the organization. Ensure high customer satisfaction in line with BUPA values and business strategy.
- Efficiency management: Ensure achieving the daily targets in terms of productivity & speed of response.
- Ensure proper interpretation and usage of clinical skills.
- Compliance to policy and Regulation: Report all high value claims as per agreed process.
- Highlight and report fraud, abuse, and anti-selection.

**Skills**:

- Ability to conduct business in English language.
- Ability to work under pressure.
- Strong communication skills.
- Clinical experience in general practitioner or Emergency or Family Medicine.

**Education**:
MBBS (Bachelor of Medicine & Surgery) with some expertise of Insurance is preferred.


  • Doctor

    12 hours ago


    المملكة العربية السعودية, Saudi Arabia Smart Resourcing International (SRI) Full time

    Reputed Client of Smart Resourcing International KSA, Saudi ArabiaOne of our reputed Hospital in KSA Doctor Interview Mode: CV Selection followed by Video conferencing Doctor: - Specialist Pediatrics (NICU) Qualification: - MBBS+MD/DNB Salary Range - 20,000 SAR Plus Accommodation Transportation and Medical Insurance ***: Updated CV Education...


  • المملكة العربية السعودية, Saudi Arabia Zahrawi Medical Full time

    **About Zahrawi Group**: Zahrawi Group is a leading company in the GCC Healthcare Industry with its presence in UAE, KSA, Qatar, Bahrain, & Oman markets. The company supplies and distributes high-quality products and services to Hospitals, Clinics, Laboratories, & Analytical Industries. **job Brief**: The incumbent will be accountable to promote products...


  • المملكة العربية السعودية, Saudi Arabia Talent Pal Full time

    The jobs in this level are the link between the company and healthcare professionals. Aim is it to increase the awareness and use of Hikma’s pharmaceutical and medical products through the sales and marketing activities and services including field activities. Job holders promote a defined set of products to customers and/or key accounts, in accordance...


  • المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    Supervise daily administrative operations. - Monitor expenses and suggest cost-effective alternatives. - Develop and implement effective policies for all operational procedures. - Prepare work schedules. - Maintain organized medical and employee records. - Monitor administrative staff’s performance. - Ensure prompt ordering and stocking of office...

  • Medical Quality

    5 days ago


    المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full time

    Overseeing and ensuring the integrity of quality and risk management processes across all medical activities. Will also ensure the quality of reported unaccepted critical incidents/sentinel events from TPA accounts, ensuring alignment with established quality benchmarks, identifying risks, formulating mitigation strategies, overseeing needed data...

  • Medical Insurance

    7 days ago


    المملكة العربية السعودية, Saudi Arabia Nahdi Full time

    Establish, Leading and developing the Medical Insurance Business strategy, corporate sales function to sign credit sales deals and Revenue Cycle Management (RCM) to achieve 80% revenue of group of polyclinic by representing company negotiating and signing insurance contracts and expansions of network to ensure achieving the business targets for the...

  • Orthopedician saudi

    12 hours ago


    المملكة العربية السعودية, Saudi Arabia Medisol Placements Full time

    **Job Information**: Industry **Medical** *** Work Experience **4-5 years** *** Salary **10 K+** *** City **HAIL SAUDI** *** State/Province **Ha'il** *** Country **Saudi Arabia** *** Zip/Postal Code **11564** Our Reputed Medical Centre or Clinic is looking for a compassionate Specialists doctor to join our Orthopedic - be responsible for the...


  • المملكة العربية السعودية, Saudi Arabia Talent Pal Full time

    About the job Would you like to join Danone Middle East and contribute to bringing health through food to as many people as possible? If YES, Danone Middle East is looking for a talented** HealthCare Nutrition Specialist **(medical representative) to be based in **Riyadh, Saudi Arabia **, like you! In the context of Specialized Nutrition Middle East, you...


  • المملكة العربية السعودية, Saudi Arabia Danone Full time

    About the job Would you like to join Danone Middle East and contribute to bringing health through food to as many people as possible? If YES, Danone Middle East is looking for a talented** HealthCare Nutrition Specialist **(Medical representative ) to be based in **Qassim, Saudi Arabia **, like you! In the context of Specialized Nutrition Middle East, you...


  • المملكة العربية السعودية, Saudi Arabia Danone Full time

    About the job Would you like to join Danone Middle East and contribute to bringing health through food to as many people as possible? If YES, Danone Middle East is looking for a talented** HealthCare Nutrition Specialist **(medical representative) to be based in **Al Kharj, Saudi Arabia **, like you! In the context of Specialized Nutrition Middle East, you...


  • المملكة العربية السعودية, Saudi Arabia Dita Consulting Full time

    Consultant Microbiologist & Immunologist مستشفى القوات المسلحة بحفر الباطن **Responsibilities**: Duties and Responsibilities: Abides by the Medical Staff Bylaws, Code of Medical Ethics, Rules and Regulations of the Medical Staff and those specific to the Department. Responsible for the provision and maintenance of an efficient...

  • Account Manager

    12 hours ago


    المملكة العربية السعودية, Saudi Arabia Talent Pal Full time

    About the job Key Account Manager - KSA - Eastern Region Job Title: Key Account Manager Country: Saudi Arabia Locations: Eastern Region - Dammam or Khobar **Job Purpose**: To meet the key performance indicators for executing the strategic directions and Goals by promoting and provide the access of our products to the healthcare professionals in reference...


  • المملكة العربية السعودية, Saudi Arabia Danone Full time

    About the job Danone MENA is looking for a talented Healthcare Nutrition Specialist (Medical Representative) to be based in Riyadh, Saudi Arabia like you! In the context of Specialized Nutrition Mena, you will be responsible to drive and contribute to SN brand market share in the assigned area, build productive scientific-based HCP relationships, taking...

  • Hse Officer

    4 days ago


    المملكة العربية السعودية, Saudi Arabia Talent Pal Full time

    **13/11/2018**: Date **2047**: Job Code **PURPOSE**: Monitor and inspect all HSE activities at company’s construction sites and ensure its compliance with applicable standards. **RESPOSIBILITIES**: Ensure full adherence to the Al Toukhi’s HSE polices procedures and standard. Provide production operation input into the safety cases. Coordinate...