Clinical Governance Supervisor – AXA Insurance (Gulf) B.S. C. (c )

Job Purpose
• Develop and implement evidence-based practices
• Ensure and monitor quality of medical decisions
• Develop, implement and monitor clinical outcomes
• Govern clinical decisions across all medical operational teams
• Manage pharmacy claims through Pharmacy Benefit Management (PBM) system and PBM call center department
• Manage close file review
Main Accountability:
• Developing, implementing and maintaining Clinical Guidelines based on the areas of risk identified across all audit activities
• Building a robust mechanism of continuous quality audit across all functions related to cost containment to ensure a culture of continuous monitoring and improvement
• Reviewing and improving Medical Decision Matrix to enhance Customer Experience, and Service Differentiation.
• Standardizing Medical Operational Procedures and Developing Task Specification Medical Training Manual in alignment with Business Capability Building Strategy
• Developing and delivering Training for Best Medical Practices for Clinical Staff to ensure Medical Cost Management, and Service Differentiation
• Monitoring drug utilization and proposing solution to control cost
• Govern close file review (CFR) of claims of the Gulf team and communicate the results to the internal stakeholder and group
• Propose, agree and monitor the action plan of different departments in areas where improvement is needed based on CFR results.

Job Details

Date Posted: 2017-10-24
Job Location: Dubai, United Arab Emirates
Job Role: Support Services
Company Industry: Insurance

Preferred Candidate

Career Level: Mid Career

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