Job Status: open

Position Title: Pre-Authorisation Manager

Position Based In: Saudi Arabia  

Employer / Client’s Detail: Leading Insurance Company

Gender: Male

Education: Must have successfully completed medical degree. MBA is preferable.

Experience:Must have at least 5 years experience in people management preferably in medical Insurance or as a medical director in hospitals.

Job Descriptions / Responsibilities:

• Responsible for managing the benefit spend by the business in respect of the pre-authorisation Team – ensuring that decisions are within the context of defined.
• Policy accepted guidelines, agreed treatment paths and pre-authorised financial and length of stay limits and in accordance with contract and policy.
• Develop and manage the Team, ensuring regular feedback, appropriate training and continually improving team and individual performance against stated KPI’s. Clear communication on business and performance issues with team.
• Accountable for delivering adherence to regulation requirements for pre-authorisation adjudication and turn-round within the Team.
• Jointly accountable with other teams for delivering targeted levels of Customer satisfaction.
• Contributes to the budgeting and business planning process, and accountable for the control of operational costs within the Team’s area.
• Responsible for ensuring relevant pre-authorisation information is disseminated to management, providers, clients and members.
• Continuously strive to improvement of both team and department performance.
• Creates and maintains a working environment which motivates the team and ensures the retention of the best performers.
• Ensure consistency within the Team in the approval, full/part denial of treatment; ensuring thorough and robust decisions within the context of defined policy accepted guidelines, agreed treatment paths and pre-authorised financial and length of stay limits.