Clinical Specialist Advisor

Job Description:

Clinical Specialist Advisor

Cairo, Egypt

Hybrid working options

Permanent

Full time - the role will require flexible working hours as the team operates on 24/7 shift basis

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.

We make health happen

As Clinical Specialist Advisor, you will provide clinical advice and assistance with the delivery of the final clinical reviews as needed to support other internal stakeholders including complaints and underwriting teams.

How you’ll help us make health happen:

• Clinical Complaints Handling: Deliver final clinical reviews, activate key stakeholders, and support the complaints team through various communication formats. This will include attending regular meetings to improve processes.
• Clinical Underwriting & Medical Risk Assistance: Provide specialist clinical advice and support independently through various communication formats. This will include attending regular meetings with Underwriting and Private Client Group stakeholders to enhance processes.
• Policy Review & Development: Review clinical medical policies, assist in Support Point updates, and support BI policy development as needed.

• Medical Inquiries: Proactively handle medical inquiries from internal and external customers, providing clinical advice and support through various communication formats.
• Medical Information Evaluation: Evaluate medical information to determine clinical eligibility for care, ensuring best practice and cost-effectiveness.
• Quality Criteria Compliance: Develop and comply with quality criteria for clinical case and claims management, register complaints, and ensure corrective actions are taken.
• Project Participation: Support and contribute to business-wide projects and initiatives, including planning and delivering presentations.
• Record Maintenance: Ensure electronic records are up to date with medical information, clinical decisions, advice, and communications.

Key Skills / Qualifications needed for this role:

• Qualified Doctor with license the practice in Egypt is essential
• Specialism in neuropsychiatry would be preferred
• Previous experience in international private medical insurance or in an administrative capacity within a hospital environment is preferred
• Strong Arabic and English, both written and verbal is desirable
• Strong numerical and financial reconciliation skills
• Knowledge of private hospital industry pricing and quality
• Proven track record of meeting targets with high quality
• Ability to liaise across teams and management levels
• Team player, supportive and advisory
• Commitment to ongoing training
• Flexibility to learn new skills and adapt to changes
• Empathy and professionalism in customer interactions
• Excellent communication skills with various stakeholders
• Ability to work under pressure and independently
• Strong influencing and decision-making skills

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]

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