Global Case Manager

Job Description:

Global Case Manager

Bupa Cairo Office (Egypt - Cairo, Mivida Business Park, Building 3/B1, Parcel 33, 5th Settlement, Cairo 11835)

Full Time - 40 hours per week (2-3 days per week office working)

Applicant must be Cairo based

Bupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, around the world, whether at home or when studying, living, travelling or working abroad.

Bupa Global has offices around the world including London and Brighton (UK), Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and Hong Kong (China) as well as regional offices in mainland China, Singapore, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador.

The Role

The primary goal is to evaluate and authorise clinical cases and complex medical preauthorisation and support our members during their treatment journey.

You’ll help us make health happen by:

• To investigate, and response to enquiries for complex medical pre-authorization and high value claims from different internal and external shake holders including but not limited to members, providers, service providers and intermediaries in the appropriate method, in line with Bupa Global policy and management style

• Ensure the correct interpretation of Bupa Global’s policies and rules, using the appropriate coding system to process the data and information accurately.

• Identify opportunities to reduce future claim expense for Bupa Global

• Proactively negotiate medical cost based on evidences to achieve either reduced cost to the business

• Proactively identify fraud and/or abuse and reports to appropriate parties

• Oversee member’s progress and monitor the discharge plan drafted.

• Prepare documents and reports required for internal and external shake holders in the scope of case coordination activities and/ or data collections.

• Input clinical information into computer database, under the supervision of regional case manager

• Assist Regional Contracting Manager with projects in ad-hoc basis.

Key Skills / Qualifications needed for this role

• Bachelor Degree or above in healthcare or related discipline

• Doctor or RN experience with speciality (local or overseas) is preferred OR At least 2 years of solid experience in utilization review or case management in IPMI environment.

• Knowledge of coding system

• Excellent knowledge of Microsoft Word and Microsoft Excel

• Excellent interpersonal skills and ability to work with a team

• Excellent analytical and critical thinking skills

• Respects diversity and embraces cultural difference

• Highly customer focussed and able to place customer’s health and benefit in the first priority.

• Understand the business commitment to meet deadline and turn-around time

• Proficient communication skills in English

Benefits

Our benefits are designed to make health happen for our people. Viva is our global wellbeing programme and includes all aspects of our health – from mental and physical, to financial, social and environmental wellbeing. We support flexible working and have a range of family friendly benefits.

Joining Bupa in this role you will receive the following benefits and more:

• 25 days holiday, increasing through length of service, with option to buy or sell

• Bupa health insurance as a benefit in kind

• An enhanced pension plan and life insurance

• Annual performance-based bonus

• Onsite gyms or local discounts where no onsite gym available

• Various other benefits and online discounts

Why Bupa?

We’re a health insurer and provider. With no shareholders, our customers are our focus. Our people are all driven by the same purpose – helping people live longer, healthier, happier lives and making a better world. We make health happen by being brave, caring and responsible in everything we do.

We encourage all of our people to “Be you at Bupa”, we champion diversity, and we understand the importance of our people representing the communities and customers we serve. That’s why we especially encourage applications from people with diverse backgrounds and experiences.

Bupa is a Level 2 Disability Confident Employer. This means we aim to offer an interview/assessment to every disabled applicant who meets the minimum criteria for the role. We’ll make sure you are treated fairly and offer reasonable adjustments as part of our recruitment process to anyone that needs them. 

If you require information regarding this role in an alternative format, please email: [email protected]  

Time Type:

Full time

Job Area:

Clinical Services

Locations:

Egypt - Cairo