Medical Officer – Client of Five Continents in Abu Dhabi

Job Listing No: 97412213

Medical Officer – Client of Five Continents in Abu Dhabi

Ensure effective administration of the Company’s Medical scheme and provide quality medical services to all company employees. The successful candidate should be able to carry-out the following: – Close coordination with MOH, medical service providers, Hospitals/Clinics, emergency and other support services and with ADNOC Medical department to ensure Company employees receive prompt and quality medical care. – Effective follow up and prompt resolution of all medical cases – To ensure that the medical services provided are responsive to the employees needs and requirements – Coordinating the processing of all medical cases and employee’s medical claims with the medical service providers and Insurance Company to ensure employee/customer satisfaction – Regular liaison with ADNOC Medical Department and ADNOC Clinic for pre- employment medical examination, employee’s medical check-up, medical case clarifications ,medical treatment abroad and disability payment – Regular visits and follow up of employees undergoing medical treatment in Hospitals as well as assisting employees families in critical medical cases – Coordination with Ministry of Health authorities on matters relating to preventive health care as well as with contracted hospitals regarding executive health check-up for senior management – Investigating and effectively resolving employee’s complaints on medical services, reimbursements, insurance matters and medical treatment. – Reviews and evaluates all medical cases and sick leaves and prepares necessary reports and recommendation for management review. – Collects and maintains statistical data on a monthly basis and prepares periodic reports and updates as required – Participates in risk management, claim adjudication and pharmacy utilization, case reviews, site visit coordination and assessment of medical service providers – Promotes wellness and ensures that Health awareness programs and preventive care are consistent with the Department’s plans and objectives. – Maintains up to date knowledge of new information in the medical field and their application to the Company’s Health plan and Medical policy. – Assists in the contracting process of medical service providers, Insurance Company, hospitals, ancillary providers and emergency and other support services and in evaluation of the medical aspects of provider contracts. – Implements the health plan medical policies, goals and objectives and assures plan conformance with legal and regulatory requirements. – Collaborates with ADNOC Medical Department in creating and maintaining programs to achieve preventive health care, cost and quality outcomes. – Monitors member and provider satisfaction survey results and implements changes as needed to increase satisfaction and assure that satisfactory relationships are maintained between network providers and plan participants.

– Source from NaurikiGulf UAE

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