Strategic Case Management Clinician

The National Insurance Company – Daman; Abu Dhabi; On-site; AED 180,000 - 300,000; Full time

Job summary

The National Insurance Company – Daman is seeking a Case Management professional in Abu Dhabi to conduct comprehensive clinical and utilization assessments, develop individualized care plans, and coordinate with providers and clients. You will appraise guidelines for medical necessity and ensure appropriate care across services.

Role requires 2+ years in medical authorisation or case management within health insurance or provider settings, with strong analytical and communication skills.

Qualifications

• Bachelor’s degree in Medicine, Nursing, Pharmacy, Physiotherapy, or allied health with clinical training.
• Minimum 2 years in medical authorisation, claims adjudication, or case management in health care.
• Ability to interpret medical records, diagnoses, and evidence-based guidelines.
• Understanding of policy benefits, exclusions, authorisation, and reimbursement workflows.

Responsibilities

• Perform clinical assessments to determine necessity, plan care, and collaborate with clients and providers.
• Critically appraise guidelines, document uncertainties, and escalate as needed.
• Coordinate with multidisciplinary teams to ensure cohesive care delivery.
• Investigate high-utilization events and identify barriers to appropriate care.
• Engage in follow-up assessments and case management for high-risk members.
• Operate with compliance to laws, regulations, and accreditation standards.
• Produce case summaries, provider queries, and evidence-based justifications.
• Utilize data analytics to identify trends and inform decisions.

Skills

Critical thinking

Judgement

Investigative mindset

Communication

Empathy & culture

Ownership & execution

Prioritisation

Digital fluency

Collaboration

Education

Bachelor’s degree in Medicine / Nursing / Pharmacy / Physiotherapy or allied health

Tools

Excel

Job description

The National Insurance Company – Daman is seeking a Case Management professional in Abu Dhabi to conduct comprehensive clinical and utilization assessments, develop individualized care plans, and coordinate with providers and clients. You will appraise guidelines for medical necessity and ensure appropriate care across services.

Role requires 2+ years in medical authorisation or case management within health insurance or provider settings, with strong analytical and communication skills.