Manager – Home Healthcare, Laboratory & Imaging

Bupa Arabia


Date: 3 weeks ago
City: Al Khobar
Contract type: Full time
Job Description

To improve the medical-service lines (virtual consultations, home-based care, labs & imaging) to deliver safe, cost-effective and patient-centred outcomes aligned with the growth strategy.

Home Healthcare Services

  • Implement evidence-based care protocols to improved healthcare outcomes.
  • Define and communicate chronic / nonchronic care programs and cost-effectiveness goals with internal stakeholders.
  • Manage all home healthcare services with partnered providers to assess the requiredhome healthcare service
  • Track patient journey end to end and release reports to conitune the service cycle for medicatoin delivery or SAT referrals.
  • Adjudicate home healthcare services according to the policy and TOB.
  • Communicate with members oon all touchpoints support and resolve their cases.
  • Coordinate with home healthcare services and TPAs to provide medical requirements for members
  • Collaborate with providers for future medical services for patient medical journey progress
  • Analyse data to track services performance and provide regular reports on progress
  • Suggest data-driven decisions to optimize service effectiveness

Service Recovery

  • Liaise with stakeholders at providers to ensure quality healthcare service for members
  • Check outbound calls for follow up cases with members
  • Resolve member requests received through inbound calls
  • Maintain and update a tracker for all member issues raised
  • Follow up on active cases to ensure optimal members recovery, referrals, and case resolution
  • Update medical reports, provider acceptances of patients upon completion of their medical journey
  • Maintain a database for treating physicians in home healthcare facilities for service delivery review for customer experience.

Skills

  • Communication Skills
  • Service Delivery Skills
  • Bachelor’s Degree
  • Master’s Degree is an advantage
  • Certified Medical doctor is an advantage
  • Clinical experience background
  • Quality Management
  • Experience in Insurance Industry
  • Experience in Case Management
  • Experience in Project Management
  • Professional exposure in US/Europe/Canada preferred

Education

MBBS

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