Assistant Manager - Authorization

As a member of Munich Re, the MedNet Group is a leading Third-Party Administrator across the MEA region. We are currently seeking to hire an Assistant Manager - Authorization who is responsible for managing all operations related to medical authorizations including the review, evaluation and authorization processes, in accordance with policy guidelines.

Your role:

• Plan and manage the overall operations of the medical department in order to ensure achievement of optimum customer satisfaction in accordance with established quality parameters and MedNet policies and procedures.
• Lead and manage the effective evaluation of in-hospital cases in respect of medical necessity and appropriateness and provide approval of benefits as per the policy wordings and based on medical point of view.
• Ensure strong relationship and high level of communication and efficiency between internal departments.
• Lead and manage the effective evaluation of outpatient authorizations in respect to the medical necessity and appropriateness and check them in the system to ensure adherence to policy guidelines.
• Manage the effective achievement of the authorization objectives in the department through setting individual objectives, managing performance, developing staff and providing formal and informal feedback in order to maximize overall performance and team motivation.
• Recommend improvements to departmental policy and manage the implementation of procedures and controls covering all areas of claims review, evaluation and approval activity so that all relevant procedural requirements are fulfilled while delivering a quality, cost-effective service.

Your Profile:

• Bachelor’s degree in Nursing Science, Pharmacy, Dentistry, Paramedic certificate or any related medical field.
• 8 years’ experience of medicine practice of which is at least 4 years in TPA / medical insurance sector as well as 2 years of supervisory experience.
• Ability to operate effectively with people at all levels of the business.
• Knowledge of concepts of medical insurance.