Manager - Medical Excellence Pre Authorization (Mega AC)

To ensure alignment with all decisions and regulations in terms of medical services provided and agreed contract within assigned providers are handled by the provider management, insurance office, and all stakeholders. Monitoring of Preauthorization standards regarding Customer experience and ensuring provider compliance Providing guidance for the Insurance office and management inside providers to achieve best parameters for Customer experience improvement without cost impact. Monitor customer satisfaction perception metrics inside Providers ( CSAT & TNPS ) . Ensure a high level of communication with Providers, delivering best operational mutual agreements Ensure applying terms and conditions of Bupa Policy Adherence to CHI policy and regulations Highlight and report fraud, abuse, and anti-selection Ensure achieving the daily Targets in terms of productivity Ensure proper interpretation and usage of clinical skills and operational excellence Improve decision-making skills on an individual level Follow operational instructions and apply to relevant processes Provide regular feedback, coaching and development Motivate, encourage collaboration between internal and external stakeholders Take active part in complaint management and communicate effectively (inter/intra department) Report any crisis and adhere to instructions related to it