Case Manager

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

Job summary

A leading healthcare provider in Dubai is seeking a clinical case manager to effectively manage the hospital's case management processes. The role involves coordinating patient care plans, providing clinical expertise for insurance claims, and ensuring the quality of clinical documentation. The ideal candidate should have a relevant nursing or medical degree, experience in clinical roles, and knowledge of healthcare revenue cycle management. This position offers an opportunity to impact patient care and financial outcomes significantly.

Qualifications

• At least 3 years’ experience in a clinical, insurance, medical auditing or coding role in a DRG billing environment.
• Experience in Theatre and/or ICU is preferred.
• Knowledge of healthcare revenue cycle management and billing processes.

Responsibilities

• Manage the hospital case management process efficiently.
• Coordinate patient care plans to minimise financial risks.
• Provide clinical expertise for managing insurance claims.

Skills

Application of clinical codes

Computer literacy

Proficiency in MS Office applications

Healthcare revenue cycle management

ICD-10 CM

CPT and DRG coding system

Education

Bachelor Degree or Diploma in Nursing or Medicine

Bachelors or Master’s Degree in Healthcare Management

Certificate in Clinical Coding (CCS / CCA / CPC / CPMA)

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 applications
• Electronic 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