Locum - Case Manager

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

Job summary

Mediclinic Parkview Hospital seeks a Clinical Documentation Manager to oversee the hospital case management process. The role entails coordinating patient care plans, managing clinical documentation quality, and providing expertise for insurance claims, requiring a solid educational background in nursing or medicine and experience in UAE healthcare.

Qualifications

• At least 3 years' experience in clinical, insurance, medical auditing, or coding role in a DRG billing environment.
• Experience in Theatre and/or ICU, medical insurance background preferred.

Responsibilities

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

Skills

Clinical coding

Proficiency in MS Office

Electronic Health Records systems

Healthcare revenue cycle management

ICD-10 CM, CPT, DRG knowledge

Scientific nursing processes

Education

Bachelor Degree or Diploma in Nursing or Medicine

Bachelor's or Master’s Degree in Healthcare Management

Certificate in Clinical Coding

Job description

Effectively and efficiently manage the hospital case management process and facilitate communication between all role players by providing accurate and timely clinical information to minimize the financial risk for the organization.

KEY RESPONSIBILITY AREAS

1. Effective coordination of patient care plans to minimize financial risk for the organization.
2. Manage the quality of clinical documentation effectively.
3. Provide clinical expertise for managing insurance claims with supportive medical justifications based on good clinical practice.
4. Focus on continuous quality improvement of clinical documentation.

REQUIRED EDUCATION

Essential: Bachelor Degree or Diploma in Nursing or Medicine (Non-licensed Physician).

Desired: Bachelor's or Master’s Degree in Healthcare Management from a recognized 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, including at least 1 year in UAE Healthcare.

Desired: Experience in Theatre and/or ICU, medical insurance/funders background; experience in private healthcare or as a paramedic.

REQUIRED JOB SKILLS AND KNOWLEDGE

• Application of clinical codes.
• Proficiency in MS Office applications and computer literacy.
• Experience with Electronic Health Records systems and related best practices.
• Understanding healthcare revenue cycle management and billing processes.
• Knowledge of ICD-10 CM, CPT, and DRG coding systems.
• Knowledge of scientific nursing processes and procedures.
• Experience with patient administration systems and related processes.
• Understanding of the patient journey through a hospital and contact points.