Alaa Mur Email & Phone Number

• Review Urgent patient files received and recommend a course of action for the patient that includes country of treatment, preferred hospital and physician to the Section Head - Medical Management;• Evaluate the patient.s condition with regard to any special requirements he / she might need for overseas treatment (Stretcher, oxygen, etc.);• Submit a list of patients recommended for overseas or local treatment to the Section Head - Medical Management;• Prepare requests for appointment on behalf of patients, specifying the selected medical Centre and physician and forward the request to the Overseas Medical office in the country selected for treatment;• Coordinate with overseas medical offices/UAE embassies to arrange patient.s hospital admission;• Maintain confidentiality and privacy of patient, client, and employee information in verbal, written, telephonic and electronic forms at all times in accordance with healthcare laws and regulations;• Advise the Section Head - Medical Management on the cases that should be submitted to the committee meetings with regards to the diagnosis, case type and case urgency;• Attend Medical Board Committee meetings to discuss patient cases;• Request and review all relevant information and all medical correspondences related to patients that are being treated abroad;• Maintain adequate knowledge about medical treatments provided in both local & international health care facilities;• Prepare reports to the Section Head - Medical Management regarding the status of patients being treated both locally and abroad;• Perform other tasks related to the department function as they arise and as delegated by Section Head - Medical Management.

Abu Dhabi, United Arab Emirates

• Conduct data driven on-site audits of healthcare service providers, checking and evaluating accurately the medical record and related documents of the members to assess the cases medically and the justification of the rendered services.• Investigate suspected health insurance misuse and abuse cases related to Daman members, collecting necessary documentation and as required, evidence to support his/her evaluation of the case • Ensure that business decisions and processes are documented in a professional manner with due confidentiality• Handle the Department of Health escalation, regarding abuse providers and evaluate their cases based on the guidelines and their proper justification.• Prepare the final audit report following the on-site audit and investigation; communicate with the providers regarding the audit findings and initiates the corrective actions.

Abu Dhabi, United Arab Emirates

• Responsible for all aspects of participation in contracting with the assigned providers• Implement strategies to accurately determine the cost of the provider to Daman• Ensure that all negotiations are in line with Daman’s pricing targets, optimum services and payment terms• Carry out procedure code mapping for the contracted services with the healthcare providers as needed• Review provider dashboards and quality reports to measure provider performance and utilization

Abudhabi

• review the clinical systems and procedures and determine its effectiveness • Present critical case to the morbidity and mortality committee.• Monitor the functioning of the clinic and find defects and inefficiencies within the system • Presentation patient’s case reviews, discussion with medical committee.• Analyze the organization's abilities at managing crisis and delivering prompt services • Determine the performance standards and the service quality measures for the clinic (root cause analysis-PDCA, etc)• Review clinical documentation in order to ensure that all components of the patient’s medical record are completed with quality standards and accuracy.• Assist the Clinical Educator as needed, to determine areas that require immediate remediation and ensure Unity Point employees stay ahead of changing information while improving the quality and effectiveness of documentation being submitted. • Review Urgent patient files received and recommend a course of action for the patient that includes country of treatment, preferred hospital and physician to the Section Head – Medical Management.• Work with colleagues across business units such as Care Management and Regulatory Compliance to ensure process and procedural changes are reflected in the Doctors and Nursing documentation. • Upraise certain medical cases from head committee of Mortality and Morbidity meeting to sentinel event regards to the diagnosis, case type and case urgency• Uses clinical knowledge to identify trends related to clinical outcomes • Develops standard reports in graphical format, using reporting systems, for review and distribution to various hospital or medical staff committees • Knowledge of The Joint Commission/The Joint Commission International, Health Regulators, Clinical Reporting Registries, or process and outcome measurement reporting requirements • Stay updated with regulations issued by the Department of Health, Joint Commission, (JCIA), and HAAD.

Abu Dhabi, United Arab Emirates

• Responsible to review the clinical systems and procedures and determine its effectiveness • Upraise certain medical cases from head committee of mortality and morbidity meeting to sentinel event regards to the diagnosis, case type and case urgency;• Present critical case to the morbidity and mortality committee and prepare all related medical history and physicians’ intervention for their review.• Monitor the functioning of the clinic and find defects and inefficiencies within the system • Review the stocks and ensure maintenance of sufficient quantities of essential medicines • Determine the performance standards and the service quality measures for the clinic • Study the organization's patients records and ensure accurate maintenance of information • Work with colleagues across business units such as Care Management and Regulatory Compliance to ensure process and procedural changes are reflected in the Doctors and Nursing documentation. • Knowledge of The Joint Commission/The Joint Commission International, Health Regulators, Clinical Reporting Registries, or process and outcome measurement reporting requirements • Stay updated with regulations issued by the Department of Health, Joint Commission, (JCIA), and HAAD.

Master’S Degree, Master Of Healthcare Management

Activities and Societies: o Module 1: Managing Organizations & People o Module 2: Operations & Quality Management o Module 3: Evaluation.

Bachelor’S Degree, Medicine And Surgery Bachelor Degree