Case Management Coordinator Job Vacancy in MetLife Dubai – Latest Jobs in Dubai – updated today

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Full Details :
Company Name : MetLife
Location : Dubai
Position : Case Management Coordinator

Job Description : Job Purpose:
Analyze & investigate cases and identify opportunities for alternate cost effective solutions for patients without jeopardizing the quality of care. Follow up with patients to enhance quality of care and satisfaction and promote continuity of care and cost effectiveness. Ensure treatment is in line with medical parameters and curtail abuse of care and length of stay.
Key Responsibilities:
ROI & Customer Centricity: Evaluate the appropriateness, medical need and efficiency of health care service procedures. Facilitate according to the guidelines under the provisions of applicable healthcare benefits thus resulting in financial appropriateness for the organization. Monitor and intervene where required to achieve cost efficient and quality healthcare options for patients. Arrange extra discounts on high cost pharmacies and medical consumables. A savings target is applicable for this role.
Internal Partnership: Feedback from the results of case management to pre-approval team and adjudicators to strategically identify abusive providers and development of state of art facilities for specific high cost surgeries or high cost long term care admissions. A feedback mechanism for network team on the abuse of providers to provide value at the time of re-negotiating contracts and feedback to FWA team to highlight such providers
P & L: Identification of alternate cost effective methods for hospitalizations and high risk cases thus resulting in a positive impact on P & L. Similarly identification of cost effective methods for claims and pre approval for specific procedures
Strategy: Responsible to identify doctors who will be the choice if any case is to be referred, to get the best possible outcome and cost effectiveness.
Qualifications & Skills:
Medical graduate degree
3- 5 years of experience with pre-approval and case management and have a strong knowledge of medicine to challenge providers
Possess skills to develop creative solutions for medical quality management
Ability to develop a feedback mechanism for different stakeholders
Strong communication skills

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