Urwah Admin

National Medical Care

<div>
 
 
 Summary:
 
 
 
 Responsible for the overall functioning of the BU- Business center by providing efficient leadership, proper planning and encouraging the staff of the section to follow departmental policies and procedures.
 
 
 The Business Center Head is responsible for overseeing and optimizing all revenue cycle functions of the hospital, including front-end and back-end revenue operations, medical billing, claims management, payers&rsquo; relations, and charge master control. The role ensures timely and accurate revenue capture, minimizes denials, improves collections, and supports overall business growth.
 
 
 
 
 
 
 Functional Responsibilities:
 
 
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 Ensures through his/her actions, either directly or indirectly that a superior quality of medical treatment, compassion and understanding is given to every patient served at the NMC Hospitals and Clinics.
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 Managing Front -End Revenue
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 Authorization Section
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 Upfront Collection
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 Managing Back -End Revenue
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 In &amp; Out Patients Medical Billing
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 Claim Managements.
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 Account Receivable
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 Review, revise &amp; control the Charge master.
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 Close coordination with Business Development department to implement the new payer's contracts.
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 Finalize yearly settlement with the insurance companies, Government Payers (MOH, SFH ...etc.) &middot;
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 Control the difficult discharge and self-pay not collected patients
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 Ensure up to date record of the following:
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 Monthly closing of the Medical Billing
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 Accomplishment report
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 Quality indicator report
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 Statement of account (Payers ,Patient )
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 Review the contracts of all the Insurance / Direct Companies from time to time particularly from the revenue point of view.
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 Approves and rechecks all the monthly corporate claims.
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 Responsible for the submission of the monthly claims in a timely manner to all the Contracted Companies, whether Direct or Insurance companies.
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 Has to oversee that the submitted claims are not rejected / changed by ensuring that the claims are complete in all the aspects with proper documents, investigation results, correct invoices and all other requirements.
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 Responsible for the final settlement of the rejected claims with the Insurance Companies / Direct Companies by organizing meetings with their concerned officials and report the final status of the settlement to the Director, Business Center.
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 Responsible for printing the various monthly reports for monitoring of the sections functioning and initiate steps to improve whenever indicated.
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 Meets current objectives and positions the organization for future growth. Completes daily tasks and assignments and processes large volumes of work associated with the operation of the department.
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 Builds positive relationships based on respect for others. Demonstrates a helpful positive attitude. Maintains effective communication with peers, staff and visitors.
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 Meets and exceeds expectations of internal and external customers. All organizational and departmental standards regarding quality of performance are met. Demonstrates a strong commitment to confidentiality. Participates in quality improvement programs as directed.
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 Follow all applicable polices and procedure of CMC.
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 Performs additional tasks and duties as assigned by Superiors and flexible to work in all CMC Business Units.
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 </ul>
 
 
 
 
 
 Job Specifications
 
 
 
 
 Minimum Job Qualifications Requirement (Academic, Certifications, languages, etc.)
 
 
 
 Education:
 
 
 
 Required
 
 
 <ul>
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 Bachelor&rsquo;s degree in Accounting, Finance, Healthcare Administration, or a related field.
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 </ul>
 
 
 Desirable
 
 
 
 Bachelor&rsquo;s degree in Information Technology, Computer Science, or related field preferred.
 
 
 
 
 
 
 Minimum Work Experience:
 
 
 <ul>
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 Ten (10) years experience in a similar field in large scale hospital setting. Including 5 years as a managerial role
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 Experience in the same field or working experience with an Insurance company
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 Strong knowledge of payer contracts, healthcare billing processes, medical coding, and AR management.
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 Experience with government payers (MOH, SFH, etc.) and private insurance companies.
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 Strong understanding of Saudi health insurance systems, including
 
 CCHI
 
 , and
 
 MOH
 
 claim workflows.
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 </ul>
 
 
 Certifications (Preferred):
 
 
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 CCHI Certification or training in medical insurance
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 Basic training in medical billing and coding
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 </ul>
 
 
 Skills &amp; Competencies:
 
 
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 Strong leadership and team management
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 </ul>
 
 Revenue cycle expertise
 
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 Analytical and problem-solving skills
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 Negotiation and payer relations skills
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 Communication and interpersonal skills
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 Attention to detail and accuracy
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 Ability to work under pressure and manage high volumes of work
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 Commitment to confidentiality and service excellence
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 </ul>
 
 
</div>

Head of Business Center (RCM)

<div>
 
 
 
 Job Summary
 
 
 
 
 Responsible for functions which control inpatient admission, Discharge &amp; Transfer and preparation of required records, compilation of the perpetual occupancy-census data, and providing record retention, guidelines transfer of patients and providing a visitor information service. Admission/discharges are processed daily during 24 hours shift operation coverage for the bed facility. Expected to handle responsibilities and makes decisions to solve problems with independent action
 
 
 
 
 
 
 
 Major Duties and Responsibilities
 
 
 
 
 
 
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 Ensures through his/her actions, either directly or indirectly, that a superior quality of medical treatment, compassion and understanding is given to every patient served at the NMC Hospitals and Clinics.
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 Revising patient account daily and that involves notifying the patient to pay the amount due or payment has to be paid in advance.
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 Ensures that patients' valuables are kept by the Admission Supervisor.
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 Supervision of staff following departmental policies and procedures.
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 Performs all managerial functions of the Unit level as established by management.
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 Administers and coordinates all activities for admitting, discharging &amp; transferring patients, recommends procedural or flow pattern changes and implements as approved.
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 Assures accurate maintenance of the perpetual occupancy-census data, recommends procedural changes and implements as directed.
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 Resolves administrative problems through established policies or responds to emergency situations with out-of-policy, recommends policy changes and implements as approved.
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 Provides functional guidance to all general service functions to assure proper processing on all inpatients and to assure coordinated efforts.
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 Implements policies pertaining to the conduct of patients such as visiting, smoking, valuables, clothing and others, and recommends changes as necessary.
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 Manages in-Kingdom patient transportation activity that ensures necessary liaison between medical services and/or corporate transportation. Notifies employees to arrange for discharge of patients or makes special admission transport arrangements.
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 Prepares unit staffing, budget or other periodic reports.
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 Assures proper on-job training of subordinates. Develops subordinates for more efficiency.
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 Conducts admission/discharges/transfer activities to meet standards of the JCIA legal requirements and established practices, bylaws and regulations.
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 Keeps abreast of new systems/procedures in admission/discharge and recommends these for approval, implements as approved.
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 Arranges all admissions, discharges, and transfers through the hospital.
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 Matches the monthly invoices of the hospital s against the actual utilization through the Patient Care System and points out any discrepancies to the Fiscal Affairs Department and Management.
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 Supervises the Central Scheduling Office for scheduling patients for admission or transfer to other hospitals.
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 Work is conducted in a professional manner maintains patients confidentiality when required.
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 Follows all department polices and procedures.
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 Participates in on-going education program developed by the department, e.g. Department Policy and Procedures, Fire Safety, Risk Management, Environmental control.
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 Performs additional tasks and duties as assigned by the management.
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 </ol>
 
 
 
 
 
 
 Reporting to
 
 
 
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 Director of Patient services
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 Supervises
 
 
 
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 ADT Supervisor
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 ADT Clerk
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 Case Management Supervisor
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 Case Management Coordinator
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 </ol>
 
 
 
 
 
 
 Qualifications:
 
 
 
 
 Education
 
 <ul>
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 Bachelor&rsquo;s Degree in Healthcare or Business Administration
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 </ul>
 
 
 
 
 A minimum of:
 
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 (5) year&rsquo;s experience in Hospital Patient Services areas
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 Fluent in English and Arabic Language
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 Computer literate (MS office)
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 Familiar with Medical Terminology
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 </ul>
 
 
</div>

Head Of Admission Section

<div>
 
 
 
 Job Summary
 
 
 
 
 Consultant is responsible for providing care for his/her patients (inpatient and outpatient) maintaining a high-level of professional performance in accordance with:
 
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 Evidence based medicine.
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 Professional medical ethics and CBHAI / JCIA standards.
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 Hospital medical by-laws.
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 Laws of Ministry of Health in Kingdom of Saudi Arabia and any other
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 applicable regulations according to the departmental quality plan.
 
 
 Providing effective leadership of the department maintaining an appropriate quality plan using measurable performance improvement standards in the field of rehabilitation.
 
 
 
 
 
 
 
 Major Duties and Responsibilities
 
 
 
 
 
 
 <ol>
 <li>
 Ensures through his actions, either directly or indirectly, that a superior quality of medical treatment, compassion and understanding is given to every patient served at the NMC Hospitals and Clinics.
 </li>
 </ol>
 
 
 
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 Provides patient care within the parameters of their professional competence as reflected in the scope of their clinical privileges for both in-patients and out-patients.
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 </ol>
 
 
 
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 Practices within the framework of clinically relevant and scientifically valid standards, guidelines and criteria.
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 Conducts regular ward rounds on his own and/or as a team to formulate a multi-disciplinary treatment plan.
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 Performs diagnostic and therapeutic procedures on his/her patients within the range of the specialty.
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 Assessment and referral of appropriate patients under his/her medical care to other appropriate medical facilities as well as accepting referrals of patients with medical problems in his/her field of specialty.
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 Participate in the on-call rota of the department for patient care and admission.
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 Responds to emergencies to offer advice and actively participate with problems if required, related to his/her specialty.
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 Observes and upholds the patient&rsquo;s rights of security, confidentiality and privacy.
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 Maintains appropriate records of all patients with accurate, timely legible completion of patient&rsquo;s medical records.
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 Consultant has a leadership role in the organization performance.
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 Supervision of duties of assigned junior staff.
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 Provides leadership for performance-improvement functions in the process of measurement, assessment and improvement of both clinical and non-clinical process as part of the Departmental Quality Plan.
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 Active participation in Continued Medical Education (C.M.E.) through educational hospital activities (morning report meetings, grand rounds, clinical tutorials and seminars, journal club, radiology or clinico-pathological conferences).Also, through National and International meetings, conferences and symposia. Participation in review of literature, case reporting and clinical studies/research.
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 Active participation in training program related to his field and organization within the hospital for training of junior medical staff and in-service training for nursing staff and technicians.
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 Continuous update of his knowledge in the medical field as well as continuously upgrading level of skill in his/her field of profession.
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 Participation in committee meetings assigned to him/her (e.g. Quality Improvement, Infection Control, etc).
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 Abides by Department Policies and Procedures, as well as hospital by-laws, Rules and Regulations.
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 Responsible to educate patients /families as per their needs and to implement their whole role regarding patient / family education process as mention in patient &amp; family education policy and procedure including documentation in patient medical record.
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 They are knowledgeable about their essential role in patient and family education.
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 Involves the patient/families in plan of care and respects patients/families regarding their goals and choices of patient care.
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 Provides health promotion and health teaching thru methods appropriate to a patients&rsquo; developmental level, learning needs, readiness and ability to learn, language preference, culture and situations.
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 Allots time necessary to assess, plan implement and evaluate patient education provided to patients/families with appropriate documentation.
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 To carry out any other assignments as directed by Hospital Administration and/or the department head and within the realm of his knowledge, skills and abilities.
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 Reporting to
 
 
 
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 <li>
 Head of Department
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 </ol>
 
 
 
 
 
 Liaises with:
 
 
 
 Consultants of his/her specialty, of other specialties within the department, Consultants of other departments, Rehabilitation Staff, Physiotherapy Department, Nursing staff and other health care professionals, patients and their families.
 
 
 
 
 
 
 
 Supervises
 
 
 
 <ul>
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 Senior Registrars, Registrars, Residents, Nurses, Rehabilitation Staff, Physiotherapy Staff and other paramedical staff assigned to him.
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 </ul>
 
 
 
 Qualifications:
 
 
 
 
 A minimum of:
 
 
 
 
 <ol>
 <li>
 
 EDUCATION :
 
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 </ol>
 <ul>
 <li>
 
 Required
 
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 </ul>
 
 Either American Board, or Canadian Fellowship, or MRCP, or Equivalent
 
 <ol>
 <li>
 
 Desirable
 
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 </ol>
 
 Higher qualifications in his specialty, if any.
 
 
 
 EXPERIENCE
 
 :
 
 <ul>
 <li>
 
 Required
 
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 </ul>
 <ol>
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 Minimum five (5) years experience Post Qualification.
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 Current valid license to practice medicine in the area of specialty.
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 Registration in Saudi Commission for Health Specialties and/or
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 Current license to practice medicine in Saudi Arabia.
 
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 Desirable
 
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 Additional experience in a sub-specialty
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 Academic affiliation.
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 </ol>
 
 
 Competencies &amp; skills:
 
 
 
 
 
 <ol>
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 Demonstrates leadership and administrative skills.
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 Fluent in spoken and written English.
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 Communication in spoken Arabic is desirable.
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 Exhibits professionalism and excellent interpersonal communication skills.
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 Is knowledgeable of the Medical by-laws.
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 Knowledge of computer application.
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 </ol>
</div>

Consultant Physical Medicine& Rehabilitation

Join National Medical Care and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

National Medical Care

ABOUT_COMPANY

Head of Business Center (RCM)

Head Of Admission Section

Consultant Physical Medicine& Rehabilitation