Manager Healthcare Services

About the Role

Bupa Arabia is seeking a Manager - Healthcare Services to join their team in Jeddah. This full-time role focuses on resolving internal escalations related to non-approved pre-authorization cases and ensuring member satisfaction through effective communication and clinical review coordination. The position requires 2-5 years of relevant experience.

Key Responsibilities

• Manage internal escalations for non-approved pre-authorization cases.
• Coordinate clinical reviews for escalated cases.
• Collaborate with Medical, Operations, and Customer Care departments to ensure timely case resolution.
• Track open escalations to manage and control case backlogs effectively.

Member Recovery and Service Excellence

• Conduct recovery reviews for eligible cases as defined.
• Engage with members to understand and address their concerns.
• Communicate case outcomes to members with clarity.
• Follow up after adverse service experiences to rebuild member confidence.

Continuous Improvement and Analysis

• Analyze escalations, complaints, and rework drivers to identify underlying root causes.
• Identify process gaps and opportunities for improvement.
• Recommend corrective and preventive actions for approval.
• Coordinate agreed actions with cross-functional stakeholders.

Qualifications and Experience

• A minimum of 2 to 5 years of relevant professional experience.
• Demonstrated ability to manage complex case escalations.
• Strong communication skills for interacting with members and internal teams.

Work Environment

This is a full-time position based in Jeddah, focusing on critical healthcare service management within a dynamic team environment at Bupa Arabia.