Health Coordination (TPA)

Role Purpose:

The Healthcare Coordinator at Bupa Connected Care plays a pivotal role in ensuring exceptional patient-centered services, compliance with operations Excellence, and effective management of Onsite Cases . They also foster positive relationships with hospitals, address customer complaints, and maintain a professional appearance to enhance the overall patient experience.

Key Accountabilities:

1- Engagement with Patients, Hospital Staff and Care Connects business units

• Follow CARE CONNECT’s procedures as outlined in the manual to comply with the department’s procedures and standards
• Follow up on all Medical requests such as but not limited to admission, medication dispensing , lab, radiology, medical Information retrieval and Referral etc.
• Facilitate administrative task related admissions, discharges and transfers of patients and release of information for continuation of care
• Maintain a thorough knowledge of all departments, our company network of hospitals, products and services so that customers are provided accurate information on it’s provider and proceed general queries with confidence at all times
• Recognize possible issues and acts proactively to avoid a negative impact
• Deal competently with members , hospital Staff feedback and take all possible actions to resolve the issues to their fullest satisfaction with minimal intervention of team leaders.
• Manage to support medically Maternity , Pediatric and Special needs medical cases

2- Teamwork Support;

• Work effectively both individually and as part of a team to achieve both individual and department goals and objectives
• Strive consistently to promote a positive team spirit
• Contribute to the team positively

3- Providers' compliance;

• Ensure that the hospital is compliant with the agreed upon standards of service with our company and that they deliver such standards to the members at all times.
• Ensure that the hospital is utilizing any of the technical services linked to our company.
• Play a support role for the hospital staff (Insurance , Pharmacists, Lab and Radiology, etc.) and enable coaching and training on CARE CONNECT Protocol / services to the hospital staff

4- Complaints management;

• Solve the customer complaints / Service Failure without the need of further escalations
• Ensure the proper follow up of the recovery plan / take a lead to standardize the proposed solutions (Kaizens , RIM ,JDI, etc.)
• Ensure that the complaints are entered into the Service escalation tools so as to take preventive actions

5- Hospital Relationship building;

• To establish excellent relationships with the providers insurance directors, CARE CONNECT Clerks and Point of Care delivery teams
• To ensure that the image of the providers in front of the customers is strengthened giving further boost to the partnership framework

6- Professional appearance and commitment;

• To ensure the office, customer area and their personal appearance is at the highest level of cleanliness, order and professional look.

• Healthcare, Patient care, Medical Coordinator
• Multi-cultural with interpersonal and communication skills, excellent planning
• maintain control and order under stressful conditions and periods of high unit activity, while utilizing effective and respectful communication with patients, families, and the health care team
• Demonstrate effective and respectful communication with patients, families and the healthcare team, using excellent interpersonal skills
• Ability to adapt to a rapidly changing environment
• Ability to quickly and appropriately prioritize tasks and manage interruptions
• Ability to multi-task with multiple requests being asked at once
• Complete work timely and accurately
• Work effectively and collaboratively within a team environment
• Commercial skills in combination with service focused mindset

Bachelor's degree in nursing or pharmacy or any related medical field