Manager Healthcare Services

About the Role

Bupa Arabia is seeking a Manager Healthcare Services to join their team in Makkah, with operations spanning Jeddah and Makkah. This full-time role focuses on resolving internal escalations related to non-approved pre-authorization cases, aiming to restore member confidence through effective communication and coordinated clinical reviews.

Key Responsibilities

• Handle internal escalations of 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 predefined eligible cases.
• Engage with members to understand and address their concerns.
• Clearly communicate case outcomes to members.
• Follow up after adverse service experiences to rebuild member confidence.

Continuous Improvement and Analysis

• Analyze escalations, complaints, and rework drivers to identify 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

Candidates for this position should possess 0-1 years of relevant experience. The role requires a proactive approach to case management and a commitment to service excellence.

Work Environment

This is a full-time position based in the Makkah region, covering operations in Jeddah and Makkah. The role involves working within a dynamic environment focused on healthcare services and member satisfaction.