Healthcare Service Escalations Manager

Bupa; Jeddah; On-site; SAR 180,000 - 240,000; Full time

Job summary

Bupa in Saudi Arabia seeks a Manager – Healthcare Services to resolve internal escalations of non-approved pre-authorization cases and restore member confidence through clear communication and coordinated clinical review.

You will lead cross-functional teams across Medical, Operations and Customer Care, manage case backlogs, perform root-cause analysis and drive process improvements to enhance service recovery and member satisfaction.

Qualifications

• Bachelor’s degree in Medicine and Surgery.
• Experience with healthcare insurance operations and pre-authorization processes.
• Strong case management and service recovery knowledge.

Responsibilities

• Handle internal escalations of non-approved pre-authorization cases.
• Coordinate clinical review of escalated cases.
• Coordinate with Medical, Operations and Customer Care to resolve cases on time.
• Track open escalations to control the case backlog.
• Conduct recovery reviews for predefined eligible cases.
• Contact members to understand and address their concerns.
• Communicate case outcomes to members clearly.
• Follow up after adverse service experiences to restore member confidence.
• Analyse escalations, complaints and rework drivers to identify root causes.
• Identify process gaps and improvement opportunities.
• Recommend corrective and preventive actions for approval.
• Coordinate agreed actions with cross-functional stakeholders.

Skills

Pre-authorization processes

Policy interpretation

Case management

Customer experience

Analytics & reporting

Quality assurance

Process improvement

Data visualization

Risk escalation

Stakeholder management

Communication

Education

Bachelor’s degree in Medicine and Surgery

Job description

Bupa in Saudi Arabia seeks a Manager – Healthcare Services to resolve internal escalations of non-approved pre-authorization cases and restore member confidence through clear communication and coordinated clinical review.

You will lead cross-functional teams across Medical, Operations and Customer Care, manage case backlogs, perform root-cause analysis and drive process improvements to enhance service recovery and member satisfaction.