Case Management & Utilization Lead

Allianz Popular SL.; Abu Dhabi; Presencial; AED 300.000 - 420.000; Jornada completa

Descripción de la vacante

Allianz Partners in Abu Dhabi is seeking a Case Management Utilization Review Specialist to manage high-cost cases, ensure timelines and compliance, and report to the Assistant Manager.

You will develop and implement case management protocols, identify cost drivers, coordinate with providers and payers, audit savings reports, and drive monthly savings targets while upholding data governance and ethical AI standards.

Formación

• Bachelor's of Medicine (MBBS) with valid licensure.
• 5+ years medical practical experience, insurance/TPA experience a plus.
• Proficient in MS Office (Excel, Word, Outlook, PowerPoint) and internet research.
• Legally permitted to work in the UAE and physically fit for duties.

Responsabilidades

• Develop and implement case management protocols and train the team.
• Identify clinical cost drivers to plan Field Control Officers or File Reviews.
• Manage high-risk and long-stay cases.
• Audit and sign off the monthly case management savings report.
• Coordinate with Providers & vendors to get cost-effective outcomes.
• Ensure timely closure of disputed cases with insurance payers.

Conocimientos

MS Office

Educación

MBBS

Descripción del empleo

Allianz Partners in Abu Dhabi is seeking a Case Management Utilization Review Specialist to manage high-cost cases, ensure timelines and compliance, and report to the Assistant Manager.

You will develop and implement case management protocols, identify cost drivers, coordinate with providers and payers, audit savings reports, and drive monthly savings targets while upholding data governance and ethical AI standards.