Pre-authorization medical Officer

-Review in-patient & out-patient approval requests in accordance with medical guidelines, CCHI and policy coverage

-Review a healthcare service that another clinical professional might propose to a plan member

-Determine whether the service is medically necessary and appropriate and whether the health plan will cover it

-Collect information and data about the adherent, not only to make particular authorization decisions but also to monitor utilization and promote Quality and cost-effective care

-Provide response (Approve / Reject) coverage as per TAT

• BSC in medicine & surgery
• Minimum 2 years clinical experience at reputable and recognized hospitals and health institutions
• Previous experience in similar position (Patient Services/approvals- minimum of 2 years)
• Decision making and Problem-solving skills
• Active listening and Excellent communication skills
• Team work skills
• Advanced skills in Microsoft excel and Word
• Initiative, persuasive, flexible, and supportive
• Fluent spoken and written English, Arabic language.