Clinical Case Specialist

Overview

• We are hiring an experienced **professional** to support healthcare operations by coordinating patient care, facilitating medical service approvals, and ensuring compliance with clinical and regulatory standards.
• The role focuses on improving patient outcomes through effective case coordination, clinical assessment, and collaboration with healthcare providers and insurance teams.
• ***Key Responsibilities:***
• Review and assess medical cases for approvals and care coordination
• Develop and monitor individualized patient care plans
• Conduct concurrent medical record reviews and ensure compliance with clinical guidelines
• Coordinate with healthcare providers, insurers, and internal stakeholders for seamless patient support
• Support complex medical cases, escalations, and utilization management activities
• Monitor case management KPIs and recommend process improvements
• Ensure compliance with healthcare regulations and quality standards
• Prepare reports, analyze service gaps, and support operational excellence initiatives
• ***Requirements:***
• Bachelor’s Degree in Nursing, Healthcare Management, Medicine, or related field
• Master’s Degree or professional certifications such as CCM/CPHM will be an advantage
• 2–4 years of experience in case management, healthcare operations, or medical insurance
• Strong knowledge of clinical assessment, medical authorization, and healthcare regulations
• Excellent communication, coordination, and stakeholder management skills
• Pay: AED5,000.00 - AED10,000.00 per month