Bupa Nurturing Program - Healthcare Services (Tamheer)

• Review cases appearing on the Medical Care Unit list either diverted from Pre-Authorization work list or created by other stakeholders to ensure the quality of the decision as well as the application of Table of Benefit guidance
• Applying the processes of case management for the work-list cases through interaction with providers, customer care and other stake holders to guarantee the optimum management of cases in order to enhance Customer experiences
• Working in close contact with external stakeholders to increase the collaboration towards better Customer experiences
• Direct interaction with clients through phone calling for explanation of decision, process and obtain necessary data or perform investigations when needed as part of the case management
• Act as a medical reference backline support to front
• Good communication skills and amble knowledge of medical practices and capable of working under pressure and high standard service delivery requirements
• Capability to work within the frame of legal and operational requirements which defines the guidelines of interaction with clients either imposed by Bupa, regulators, or the client institution

• Strong logical, analytic, Presentation, assessment, and interpretation skills
• Advanced communication and negotiation skills
• Strong troubleshooting, problem-solving and analytical skills, excellent follow up skills
• Ability to effectively prioritize and execute tasks in a high-pressure environment

• Bachelor's degree in clinical pharmacy or dentistry