Provider Medical Qc

2 months ago


Jeddah, Saudi Arabia Bupa Arabia Full time

Building Quality Control Models that capture the required transactions in any given stream.
- Perform the Quality Control Process: that includes, and not limited to, sampling, validation and releasing the related scorecards across all the functions under the scope of the Medical Quality (Preauthorization, Claims, Re-Imbursement and CS).
- Perform all NPS related activities such as case validation and members recovery.
- Improving BUPA members’ experience and satisfaction levels.
- Leads on improvement activities across all the functions under the scope of the Medical Quality such as Coaching, communicating quick fixes and OPLs and structuring Kaizens.
- Conduct the needed data analysis/management to understand the performance trends.
- Good communication skills with all involved stakeholders to enable smooth function progress.
- Quarterly presentation showing function performance level and drive actions for raising the customer experience.

**Skills**:

- Excell & PowerPoint Advance use.
- Excellent medical knowledge
- Analytic thinking
- Presentation and communication skills.

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



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