Case Manager

Mediclinic City Hospital; Dubai; On-site; AED 120,000 - 200,000; Full time

Job summary

A prominent healthcare organization in Dubai seeks an experienced professional to manage case management processes effectively. Responsibilities include coordinating patient care plans, ensuring high-quality clinical documentation, and supporting insurance claims management. The ideal candidate will have a Bachelor's degree in Nursing or Medicine, and at least 3 years of relevant experience in the UAE healthcare sector, along with knowledge of clinical codes and healthcare processes.

Qualifications

• 3+ years of experience in a clinical or medical auditing role in a DRG billing environment.
• 1 year of experience in UAE Healthcare.
• Experience in Theatre, ICU, or Insurance operations desired.

Responsibilities

• Coordinate patient care plans to minimize financial risk.
• Manage quality of clinical documentation.
• Provide expertise for managing insurance claims.

Skills

Application of clinical codes

Computer literacy and proficiency in MS Office

Healthcare revenue cycle management

ICD-10 CM, CPT and DRG coding system

Scientific nursing processes

Education

Bachelor Degree or Diploma in Nursing or Medicine

Bachelors or Master’s Degree in Healthcare Management

Job description

MAIN PURPOSE OF JOB

Effectively and efficiently manage the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimise the financial risk for the organisation

KEY RESPONSIBILITY AREAS

• Effective coordination of patient care plans to minimise financial risk for the company
• Effectively manage the quality of clinical documentation
• Provide clinical expertise for managing insurance claims with the supportive medical justifications based on good clinical practice
• Focus on continuous quality improvement of clinical documentation

REQUIRED EDUCATION

• Essential : Bachelor Degree or Diploma in Nursing or Medicine Non-licensed Physician
• Desired : Bachelors or Master’s Degree in Healthcare Management from a recognised institution Certificate in Clinical Coding (CCS / CCA / CPC / CPMA)

REQUIRED EXPERIENCE

• Essential : At least 3 years’ experience in a clinical, insurance, medical auditing or coding role in a DRG billing environment within the UAE of which at least 1 year was in UAE Healthcare
• Desired : Experience in Theatre and / or ICU, Medical Insurance / funders background; experience in private healthcare environment or experience as a paramedic

REQUIRED JOB SKILLS AND KNOWLEDGE

• Application of clinical codes
• Computer literacy and proficiency in MS Office applicationsElectronic Health Records systems and related best practice
• Healthcare revenue cycle management and billing processes
• ICD-10 CM, CPT and DRG coding system
• Knowledge of scientific nursing processes and associated procedures

Patient administration systems and related processes

Understanding of and working knowledge of the typical patient journey through a hospital and the various service points of contact