Manager - Home Healthcare, Labor...
Riyadh, Saudi Arabia
Manager - Home Healthcare, Laboratory & Imaging
Riyadh, Saudi ArabiaPosted 20 hours ago1 open position
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Job Description
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.
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
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.
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
Job Requirements
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
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
