Executive Manager- Healthcare services Process (TPA) - Pipeline

OverviewTo oversee medical care unit for TPA account, to ensure that all medical care unit sub units are delivering the PG and the decisions taken by the team are as per defined policy guidelines that are compatible with high medical standards that help safeguard member’s health & safety and also being compliant with IA, clients Regulations & BUPA values, managing the rejection recovery, referral management and occupational checkup.ResponsibilitiesService Management: Grant that team is delivering the agreed PG's with clientService Management: Ensure the decisions taken by the team are according to the best medical standards and agreement’s terms & conditions in order to prevent abuse, fraud and overtreatmentQuality medical decision & Patient safety: Ensure working with high quality of decision making with Zero QDI (Quality Demerit Index) A or BQuality medical decision & Patient safety: Ensure the medical decisions are consistent and are implemented based on clinical and practice guidelines signed off by the organizationQuality medical decision & Patient safety: Ensure high customer satisfaction in line with BUPA values and business strategyQuality medical decision & Patient safety: Ensure compliance to regulator and client during service deliveryOperation excellence: Process improvement initiatives to achieve excellenceOperation excellence: Lead the team and deliver service strategy agendaCapability Building & People Management: Ensure and facilitate goal setting; manage and constantly review individual performanceCapability Building & People Management: Provide regular feedback, coaching and developmentCapability Building & People Management: Motivate, empower and enable direct reports by providing the necessary tools and supportSupport the business & communicate effectively: Discuss & report the requested reports by the clients with involved partiesSupport the business & communicate effectively: Take active part in complaint management and communicate effectively (inter/intra department)Support the business & communicate effectively: Participate effectively in weekly monthly meetingsSupport the business & communicate effectively: Manage any crises effectively based on already set business continuity plan#J-18808-Ljbffr