Case Manager
Job Fit Check
Base Career helps you apply smarter for this job.
Key skills for this role
About the Role
Mediclinic Middle East seeks a Case Manager to manage hospital case management, coordinate patient care plans, and minimize financial risk. Requires a Bachelor's in Nursing or Medicine, 3+ years clinical/insurance experience in UAE, and knowledge of ICD-10, CPT, and DRG coding.
Key Skills for This Role
Responsibilities
- Coordinate patient care plans to minimize financial risk
- Manage quality of clinical documentation
- Provide clinical expertise for managing insurance claims with medical justifications
- Conduct concurrent and retrospective utilization reviews
- Monitor Length of Stay (LOS) and facilitate timely discharge planning
- Coordinate with physicians and insurance teams for approvals and documentation
- Collaborate with physicians, coding, nursing, finance, and insurance teams
Requirements
- Bachelor's Degree or Diploma in Nursing or Medicine (Non licensed Physician)
- At least 3 years' experience in clinical, insurance, medical auditing or coding role in a DRG billing environment within UAE
- At least 1 year in UAE Healthcare
- Knowledge of ICD 10 CM, CPT and DRG coding systems
- Computer literacy and proficiency in MS Office
- Knowledge of healthcare revenue cycle management and billing processes
- Knowledge of patient administration systems
Full Job Posting
Main Purpose of Job
- Effectively and efficiently manage the hospital case management process and facilitate the communication process between all role players by providing accurate and timeous clinical information to minimize the financial risk for the organization.
Key Responsibility Areas
- Effective coordination of patient care plans to minimize financial risk for the company
- Effectively manage the quality of clinical documentation
- Provide clinical expertise for managing insurance claims with the supportive medical justifications based on good clinical practice
- Focus on continuous quality improvement of clinical documentation
- Conduct concurrent and retrospective utilization reviews to ensure medical necessity, appropriate level of care, and compliance with payer requirements.
- Monitor Length of Stay (LOS) and facilitate timely discharge planning
- Coordinate with treating physicians and insurance teams to obtain timely approvals, extensions, and medical necessity documentation
- Collaborate with physicians, coding, nursing, finance, and insurance teams to ensure accurate clinical documentation, timely payer communication, and optimal reimbursement while maintaining compliance with regulatory and payer requirements.
Required Education
- Essential: Bachelor Degree or Diploma in Nursing or Medicine Non licensed Physician
- Desired: Bachelors or Master’s Degree in Healthcare Management from a recognized institution Certificate in Clinical Coding (CCS/CCA/CPC/CPMA)
Required Experience
- Essential: At least 3 years’ experience in a clinical, insurance, medical auditing or coding role in a DRG billing environment within the UAE of which at least 1 year was in UAE Healthcare
- Desired: Experience in Theatre and/or ICU, Medical Insurance/funders background; experience in private healthcare environment or experience as a paramedic
Required Job Skills and Knowledge
- Application of clinical codes
- Computer literacy and proficiency in MS Office applications
- Electronic Health Records systems and related best practice
- Healthcare revenue cycle management and billing processes
- ICD 10 CM, CPT and DRG coding system
- Knowledge of scientific nursing processes and associated procedures
- Patient administration systems and related processes
- Understanding of and working knowledge of the typical patient journey through a hospital and the various service points of contact
Apply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at Mediclinic Middle East
Title Registered Nurse - Radiology
Dubai, UAE
Mediclinic Parkview Hospital is looking for a Registered Nurse for the Radiology department to provide patient-centric nursing care. The role requires a Bachelor's in Nursing and at least two years of recent experience a
Title Patient Administrator
Dubai, UAE
Mediclinic Middle East is seeking a Patient Administrator at Dubai Mall to manage appointment scheduling, medical insurance processes, billing, and customer service. Candidates need 2-3 years of customer service experien
Title Radiographer | Sonographer
Dubai, UAE
Mediclinic Welcare Hospital in Dubai seeks a Radiographer/Sonographer to perform radiographic and ultrasound procedures for diagnosis and treatment. Requires a bachelor's degree or diploma in Diagnostic Ultrasound, Sonog
Title Registered Nurse - NICU
Dubai, UAE
Mediclinic Parkview Hospital seeks an experienced Registered Nurse for its NICU. The role involves delivering patient-centric, evidence-based nursing care, ensuring patient safety, and mentoring learners. Requires a Bach
Title Registered Nurse - Maternity Ward
Abu Dhabi, UAE
Mediclinic Airport Road Hospital in Abu Dhabi seeks a Registered Nurse for the Maternity Ward to provide patient-centric nursing care, ensure patient safety, and contribute to a positive patient experience. Requires a Ba
Title Medical Records Officer (ME178)
Dubai, UAE
Mediclinic Middle East seeks a Medical Records Officer to manage patient health records, ensuring integrity, confidentiality, and accessibility. The role involves overseeing medical records quality, compliance with regul
Title Patient Administration Manager
Abu Dhabi, UAE
Mediclinic Middle East seeks a Patient Administration Manager to oversee patient and front office administration, revenue cycle management, and operational service points at its Abu Dhabi hospital. The role requires a re
Title RCM Coding Educator
Abu Dhabi, UAE
Mediclinic Middle East seeks an RCM Coding Educator to provide support, guidance, and education to physicians on clinical coding, ensuring quality documentation and mitigating financial risk. The role requires a relevant
Title Registered Nurse - Radiology
Dubai, UAE
Title Patient Administrator
Dubai, UAE
Title Radiographer | Sonographer
Dubai, UAE
Title Registered Nurse - NICU
Dubai, UAE
Title Registered Nurse - Maternity Ward
Abu Dhabi, UAE
Title Medical Records Officer (ME178)
Dubai, UAE
Title Patient Administration Manager
Abu Dhabi, UAE
Title RCM Coding Educator
Abu Dhabi, UAE