Medical Officer
Abu Dhabi, UAE
Worked Performed:
Ensure effective administration of the Company’s Medical scheme and provide quality medical services to all Company employees. The successful candidate should be able to carry-out the following:
• Close coordination with MOH, medical service providers, Hospitals/Clinics, emergency and other support services and with Company Medical department to ensure Company employees receive prompt and quality medical care.
• Effective follow up and prompt resolution of all medical cases
• To ensure that the medical services provided are responsive to the employees needs and requirements
• Coordinating the processing of all medical cases and employee’s medical claims with the medical service providers and Insurance Company to ensure employee/customer satisfaction
• Regular liaison with Company Medical Department and Company Clinic for pre- employment medical examination, employee’s medical check-up, medical case clarifications ,medical treatment abroad and disability payment
• Regular visits and follow up of employees undergoing medical treatment in Hospitals as well as assisting employees families in critical medical cases
• Coordination with Ministry of Health authorities on matters relating to preventive health care as well as with contracted hospitals regarding executive health check-up for senior management
• Investigating and effectively resolving employee’s complaints on medical services, reimbursements, insurance matters and medical treatment.
• Reviews and evaluates all medical cases and sick leaves and prepares necessary reports and recommendation for management review.
• Collects and maintains statistical data on a monthly basis and prepares periodic reports and updates as required
• Participates in risk management, claim adjudication and pharmacy utilization, case reviews, site visit coordination and assessment of medical service providers
• Promotes wellness and ensures that Health awareness programs and preventive care are consistent with the Department’s plans and objectives.
• Maintains up to date knowledge of new information in the medical field and their application to the Company’s Health plan and Medical policy.
• Assists in the contracting process of medical service providers, Insurance Company, hospitals, ancillary providers and emergency and other support services and in evaluation of the medical aspects of provider contracts.
• Implements the health plan medical policies, goals and objectives and assures plan conformance with legal and regulatory requirements.
• Collaborates with Company Medical Department in creating and maintaining programs to achieve preventive health care, cost and quality outcomes.
• Monitors member and provider satisfaction survey results and implements changes as needed to increase satisfaction and assure that satisfactory relationships are maintained between network providers and plan participants.
Minimum Requirements:
• Aged 35 -55
• Bachelors in Public Health administration with recognized MOH certification.
• 10 years experience in medical health administration in a medical healthcare environment, MOH establishment.
• Knowledge of medical and quality improvement practices in a managed medical care environment
• Excellent verbal and written communication skills to interface with medical service providers, staff and management
• Ability to manage difficult peer situations arising from medical care reviews with sensitivity towards the employee population
• Ability to manage multiple priorities and deadlines in an expedient and decisive manner
• Good analytical and problem solving skills with planning and organizing capabilities.
• Strong Interpersonal skills with the ability to respond promptly to customer needs and meet commitments
• Must be computer literate
Kindly send your updated CV to fivecont@emirates.net.ae and mention in the subject the position you are applying for or click here to apply.
