Manager - Healthcare Services

Role Purpose:

To deliver the healthcare services functions and supporting healthcare partner projects in order to drive the healthcare partner pillar of Bupa Arabia

Key Accountabilities;

Healthcare Operations Service Recovery:

• Liaise with medical and non-medical staff at providers to ensure quality healthcare service for our members.
• Conduct Outbound calls to our members for Wellness Coaching & case management through case interpretation or doing promotional calls.
• Receive Inbound calls from our members for wellness advices and general assistance.
• Ensure patient safety through follow up his case by providing Telemedicine consultations through our third-party partners.
• Rework any case that is related to HCS scope.
• Maintain and update a daily database and tracker of members cases & Ensure that they are highly engaged & touched.
• Conduct follow up on open cases to ensure optimal members satisfaction.
• Liaise with Bupa medical & non-medical staff to ensure a good healthcare services quality.
• Answer member consultation / coaching request with high quality according to the updated international guidelines.
• Emphasize on patient safety and confidentiality during the coaching.

 Healthcare Operations Operational Excellence:

• Engage 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 satisfaction and issue resolution.

 Healthcare Projects:

• 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:

• Conduct engagements through different Bupa Arabia channels such as chat, phone and web, and answer member queries.
• Receive Member Helpline Inbound calls from both Bupa Members and Non-Members.
• Collaborate with the Sales 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.

Education:

Bachelor’s degree on Psychology.

Other Requirements:

• Pre-Authorization/Insurance experience or clinical excellence.
• Clinical and Coaching Practice (preferred).
• Quality Management.
• Service Delivery Skills.