Medical Doctor
3 weeks ago
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
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Doctor
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المملكة العربية السعودية, Saudi Arabia Smart Resourcing International (SRI) Full timeReputed 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...
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Medical Doctor
9 months ago
المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full timeIn 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...
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Medical Representative
9 hours ago
المملكة العربية السعودية, Saudi Arabia Hikma Full timeDescription: 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...
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Medical Representative Dammam
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Specialized Medical Doctor
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المملكة العربية السعودية, Saudi Arabia Bupa Arabia Full timeIn 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...
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Medical Representative
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Medical Doctor
9 months ago
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Medication Safety Officer
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Medical Representative
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Healthcare Nutrition Specialist
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