Medical Assitant Manager- MCU

For MedNet UAE.
As a member of Munich Re the MedNet Group is a leading Third Party Administrator across the MEA region. We are currently seeking to hire a Medical Assistant Manager- Medical Care Unit with the following tasks and responsibilities.
Your Role:
Plan and manage the overall operations of the medical department in order to ensure achievement of optimum customer satisfaction with the medical review services
Le ad and manage the effective evaluation of in-hospital cases and outpatient claims in respect of medical necessity and appropriateness
Provide overall guidance and leadership to the medical team in terms of authorization activities, claims review, evaluation and as well as ensuring compliance with established policy guidelines
Manage and maintain a standardized procedures for pre-authorization, utilization review, case management, discharge planning and related medical management tools in accordance with corporate policies and guidelines
Approve medical authorization requests (as per delegated authority) if they comply with all stipulations and lead the medical auditing process and signing of all inpatients claims.
Ensure effective communication with insurance companies concerning scope of coverage issues and ensure prompt provision of solutions in accord with established corporate policies and guidelines
Ensure effective management of calls and follow up calls on medical authorization to ensure adherence to established procedures
Direct the team in issuing chronic medications as per internal guidelines and policy terms and conditions, ensure medical underwriting is performed according to Munich Re guidelines
Your Profile :
M edical degree from a university recognised by the World Health Organisation (WHO)
Minimum 5-7 years experience of medicine practice of which is at least 3 years in TPA / medical insurance sector as well as 2 years of managerial/supervisory experience
Knowledge of concepts of medical insurance
Excellent interpersonal skills and ability to communicate and work effectively with all levels of the organisation
Strong acumen and leadership skills as well as quality results oriented
Good negotiation and problem-solving skills
Good knowledge of Microsoft applications
Fluency in business English
*Munich Re not only stands for fairness with regard to its clients; it is also an equal opportunities employer.