Clinical Specialist Advisor

Clinical Specialist Advisor
Cairo, Egypt
Hybrid working options
Permanent
Full time - the role will require flexible working hours as the team operates
on ‎24/‎7 shift basis
Apply by Monday 6th February ‎2023
Here you'll be welcomed. We champion diversity and we understand the
importance of our people representing the communities and customers we serve.
You'll find an inclusive environment where you can be yourself and where
everyone is driven by the same purpose - helping people live longer,
healthier, happier lives and making a better world.
Bupa Global is the international health insurance division of Bupa. We provide
customers who want premium international coverage with products and services
to access the healthcare they need anytime, around the world, whether at home
or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK),
Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and
Hong Kong (China) as well as regional offices in mainland China, Singapore,
the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador.
Role Overview
As Clinical Specialist Advisor, you will provide clinical advice and
assistance with the delivery of the final clinical reviews as needed to
support other internal stakeholders including complaints and underwriting
teams.
What you'll do:
* Attend regular meeting with underwriting department and with Private Client Group key stakeholders in the continued development and improvement of the linked processes.
* Be accountable for Clinical Medical policy review, assist in Support Point update, and support the BI policy development if needed.
* In a professional and approachable manner, proactively deal with all types of medical inquiries from internal and external customers and provide clinical advice and complete support through the most relevant format whether that is a face-to-face meeting, telephone or written communication in relation to all often complex queries and issue resolution with limited management authority whilst working independently with minimal guidance using their extensive subject knowledge.
* Using extensive knowledge and through evidence-based reference, evaluate medical information and determine the clinical eligibility for medical care, and maintaining both best practice and cost-effectiveness.
* Identify, develop and comply with quality criteria for the clinical case and claims management and the business in general including the registration of complaints and ensure appropriate feedback is given and corrective action is taken.
* Ensuring that the electronic records reflect up to date medical information, clinical decision, advice, and communications with the member.
What you'll bring:
* Qualified Doctor with license the practice in Egypt is a requirement
* Specialism in Haematology would be preferred
* Previous experience, preferably in international private medical insurance or in an administrative capacity within a hospital environment.
* Strong Arabic and English, both written and verbal. Additional languages would be an advantage.
* Strong numerical skills and the ability to understand and produce financial reconciliations
* Knowledge of private hospital industry and its pricing and quality dynamics.
* Track record of achieving targets with a consistent high level of quality.
* Ability to liaise with different teams and at different management levels
* Good team player. Willing to support and advise colleagues
* Actively search for and attend relevant training courses.
* Flexible - ability to learn new skills and adapt to changing working practices/dynamics and environment and demonstrate a willingness to change
* Ability to be empathetic and view issues from the customers perspective while maintaining a professional outlook
* Skilled in communication, able to liaise with doctors, hospitals, brokers, members, and colleagues
* Ability to work under pressure and on his/her initiative.
* Good influencing skills with confidence and ability to challenge appropriately
* PC literate
* Organises own work effectively, works independently with minimal guidance.
* Effective decision making and investigatory skills
Time Type:
Full time