In this role you will support Bupa to ensure medical spend (In-Patient & Out-
Patient services) is controlled by ensuring that pre-authorization decisions
are within defined SAMA & CCHI regulations, accepted guidelines and high
quality medical standards, safeguarding the member's health & safety and
aligned to BUPA Values.You will be responsible for the following:- Medial cost
& Service Management: Adjudicate the cases (In-Patient & Out-Patient) based on
common medical practice and in line with Bupa protocols and policy. Ensure the
decisions are according to the best medical standards and agreement terms &
conditions in order to prevent abuse, fraud and overtreatment.- High quality
medical decision & patient safety: Ensure working with high quality of
decision making with Zero QDI (Quality Demerit Index) A or B. Ensure the
medical decisions are consistent and are implemented based on clinical and
practice guidelines signed off by the organization. Ensure high customer
satisfaction in line with BUPA values and business strategy.- Efficiency
management: Ensure achieving the daily targets in terms of productivity &
speed of response.- Ensure proper interpretation and usage of clinical
skills.- Compliance to policy and Regulation: Report all high value claims as
per agreed process.- Highlight and report fraud, abuse, and anti-selection.
- Ability to conduct business in English language.- Ability to work under
pressure.- Strong communication skills.- Clinical experience in general
practitioner or Emergency or Family Medicine.
MBBS (Bachelor of Medicine & Surgery) with some expertise of Insurance is
preferred
#### **Job Description** In this role you will support Bupa to ensure medical spend (In-Patient & Out- Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the me…
#### **Job Description** **Pre-Authorization** In this role you will support Bupa to ensure medical spend (In-Patient & Out- Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical stan…
#### **Job Description** In this role you will support Bupa to ensure medical spend (In-Patient & Out- Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the me…
#### **Job Description** **Pre-Authorization** In this role you will support Bupa to ensure medical spend (In-Patient & Out- Patient services) is controlled by ensuring that pre-authorization decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical st…
Deadline Date 2022-06-05**Specific requirements for the role:** **Education** | \- Essential: BA degree in Medicine Science or equivalent in a related allied health. ---|--- **Experience** | \- Essential: Minimum 2 years of previous experience in the position or similar. \- Desirable: Pre…
You are Doctor Specialist in Kuwait or KSA You have experience You have MOH license You are an ambitious person and looking for business opportunity we have a proposal for you as a silent partner in a clinic in Kuwait and KSA. Please send your CV and license copy whatsapp to +96599249330
Medical Doctor About the job Job Openings: Hiring the below medical doctors: Vascular Surgery (Consultant/Senior Specialist/Specialist) Pediatric Ophthalmologist (Consultant/Senior Specialist/Specialist) Dermatology (Consultant/Senior Specialist/Specialist) Interventional Radiology with specialty i…
A Reputable Medical Company is hiring the below vacancies: 1- “General Practice Doctor” • Having a valid MOH Kuwait License along with NOC or eligible to get license. • A Degree in medicine accredited and approved by MOH. • Proven experience as a General Practitioner with Nutrition background. • Ex…
وظائف الكويت اليوم: مركز دكتور ايدول الطبي تعلن عن فرص عمل جديدة . هل تبحث عن فرص عمل في الكويت ؟ مركز دكتور ايدول الطبي تعلن عن فتح باب التوظيف للعديد من الوظائف في مختلف التخصصات في الكويت بتاريخ اليوم . تتاح هذه الفرص لجميع الجنسيات. تعرف على الوظائف المتاحة وكيفية التقديم من خلال الإعلان التالي…