الوصف الوظيفي
Role purpose:
To ensure that the team delivers the healthcare partnership operations services and supports healthcare partner projects in order to drive the healthcare partner strategy of Bupa Arabia
Healthcare Operations Services
Ensure all team members do the following:
Liaise with medical and non-medical staff at providers to ensure quality healthcare service for our members
Conduct Chronic Disease Management, Medication Refill, Home-Based Lab, Natal Care, Child Vaccination Coaching, Acute Child Care, Musculoskeletal Disease Coaching
Rework any case that is medically justified, in alignment with the Pre-Authorization, to build trust with our members
Maintain and update a daily database and tracker of all issues raised and members touched
Conduct follow up on open cases to ensure optimal members recovery and issue resolution
Answer medical queries from CS, HAD/CE, Delegates, etc.
Healthcare Operations Operational Excellence
Ensure all team members do the following:
Engage Inpatient/Outpatient/Surgical members by conducting Outbound calls based on specific and clearly defined criteria
Maintain and update a database for the treating doctor and provider/hospital service delivery review of the customer experience based on clearly defined matrix and service levels
Conduct follow up on open cases to ensure optimal members recovery and issue resolution
Feed all service failures to the SMB
Prepare, support & deliver the Quarterly Treating Doctor awards in collaboration with Marketing Dept.
Quality Health Outcomes & Patient Safety
Ensure all team members do the following:
Follow validated scripts and have “Zero” Quality scoring of Criminal & Basic
Ensure health outcomes & compliance of members by building relations with members
Ensure high customer satisfaction in line with BUPA values and business strategy
Healthcare Projects
Ensure all team members do the following:
Support the delivery of healthcare projects by conducting follow up calls and coaching of our members for all healthcare projects and initiatives launched
Healthcare Operations Service Excellence
Ensure all team members do the following:
Conduct Doctor Chats through the Bupa Arabia website and answer member queries
Receive Member Helpline Inbound calls from both Bupa Members and Non-Members
Respond to Medical Helpline voice messages within the agreed KPI of 15mins
Collaborate with the Sales Relationship team and send potential leads to them
Conduct Outreach programs with Groups/Customers to promote healthcare partnership and wellness agenda
Participate in Healthcare campaigns, such as Breast Cancer, Chronic Disease Management Programs etc.
Capability Building & People Management
Ensure and facilitate goal setting; manage and constantly review individual team performance
Provide regular feedback, coaching and development
Motivate, empower and enable direct reports by providing the necessary tools and support
المهارات
EDUCATION:
Qualified, certified Medical doctor (SMO)
EXPERIENCE FIELDS
Pre Authorization / Insurance experience
Quality Management
Service Delivery Skills
Leadership and Analytical skills
Crisis Management
Team Building/Management
YEARS OF EXPERIENCE
Minimum 3 years
تفاصيل الوظيفة
منطقة الوظيفة جدة, المملكة العربية السعودية
قطاع الشركة التأمين
طبيعة عمل الشركة صاحب عمل (القطاع الخاص)
الدور الوظيفي الطب والرعاية الصحية والتمريض
نوع التوظيف --
الراتب الشهري غير محدد
عدد الوظائف الشاغرة غير محدد
المرشح المفضل
المستوى المهني إدارة
عدد سنوات الخبرة الحد الأدنى: 3
الشهادة بكالوريوس/ دبلوم عالي
https://www.bayt.com/ar/saudi-arabia/jobs/hco-team-leaders-continuity-of-care-team-leader-medical-role-4173317/
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