Clinical Excellence

9 months ago


Riyadh, Saudi Arabia Bupa Arabia Full time

Managing a group of hospitals to ensure that inpatient customers are receiving optimal healthcare services in a cost-efficient manner within agreed quality parameters along with securing the organization from fraud and abuse

**Buildng Strategic Relationships within his assigned providers’ network**
- Interacting, coordinating, building strategic relations, and dealing with consultants, medical directors and insurance offices regarding inpatient cases management

**Inpatient Members’ Engagement**
- Interacting and dealing with the inpatient members and their families to promote Bupa image, solve any issues within the provider and answering any concerns / queries

**Provider Performance monitoring**
- Flagging any abusive / overutilization trends with recommended approaches to tackle them.
- In parallel, follow up those inpatient customers are receiving optimal healthcare services in a cost-efficient manner within agreed quality parameters and ensuring members' safety.
- Make sure that approvals, rejections and invoicing are as agreed with provider management for IP cases

**Regular Informative Reporting**
- Regular daily reporting of IP cases
- Regular flagging of critical and high-cost cases

**Referral Management**
- Support the Customer Care unit in the referral process along with checking availability of needed services.

**Skills**:

- Medical Doctor
- Updated medical knowledge
- Good computer skills
- Good communication skills with patients and members
- Emotional intelligence
- Flexibility on schedule (duty timing include mornings, nights, weekends, holidays)
- Highly motivation person who like to go extra miles
- Willing to learn and participate in enhancement projects
- Ability to work as a team with his colleagues

**Education**:
Medicine and Surgery



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