Manager - Healthcare Services

Bupa; Jeddah; Sur place; SAR 180 000 - 240 000; Plein temps

Résumé du poste

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.

Responsabilités

• 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.

Connaissances

Pre-authorization processes

Policy interpretation

Case management

Customer experience

Analytics & reporting

Quality assurance

Process improvement

Data visualization

Risk escalation

Stakeholder management

Communication

Formation

Bachelor’s degree in Medicine and Surgery

Description du poste

Job Title: Manager – Healthcare Services

To resolve internal escalations of non-approved pre-authorization cases on time and restore member confidence through clear communication and coordinated clinical review.

Key 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.

Education Qualifications

Bachelor’s degree in Medicine and Surgery.

Skills Required

• Healthcare insurance operations and pre-authorization processes
• Medical policy and benefit interpretation
• Case management and service recovery methodologies
• Customer experience and complaint management
• Healthcare analytics and performance reporting
• Quality assurance and root cause analysis
• Process improvement and operational excellence
• Data visualization and dashboard interpretation
• Risk assessment and escalation management
• Communication, stakeholder management and negotiation skills

Employment / Job Type

Full Time

Nationality

Any Nationality

About the Company

Bupa is an international healthcare organisation offering health insurance and medical services to customers around the world. Its operations span hospitals, clinics, dental centres and aged care, alongside workplace health and digital consultation services. Having no shareholders, Bupa reinvests its profits back into patient care and the wider business.

Company Industry

Healthcare

Closing Date

18 December 2026