4 days ago

Approval Services Manager

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 22 hours agoStatus: Live

Job Summary

Lead the medical pre-authorization and approval function for healthcare service requests. You will set department goals, guide direct reports, and oversee review decisions for clinical appropriateness and regulatory compliance. Serve as a liaison between medical providers, internal departments, and regulatory bodies to support timely patient care approvals. Own quality assurance for approval decisions, resolve escalated cases and appeals, and report approval trends, turnaround times, and denial reasons.

Location: Riyadh

Workplace: Onsite

Employment Type: Full time

Job Function: Solutions Engineering & Sales Engineering

Seniority: Manager level

Key Responsibilities

•Set department goals and objectives and cascade them to reporting sections while guiding achievement
•Oversee medical service request review and approval, ensuring clinical appropriateness and compliance with medical guidelines and regulatory requirements
•Supervise and manage the medical pre-authorization and approval team and provide direction for delegated responsibilities
•Ensure compliance with internal protocols, payer policies, and relevant healthcare regulations; train staff on clinical policies, coding, and documentation standards
•Resolve escalated cases and appeals with the medical review board or medical director; generate reports on trends, turnaround times, denial reasons, and compliance metrics

Key Requirements

•Leverage available information to make decisions in ambiguous situations within the approval function
•Adopt new ways of conducting BAU to create agility and move away from traditional approaches
•Drive strategic direction by monitoring developments in healthcare that impact section plans
•Build team capability by identifying learning opportunities and providing job enrichment
•Communicate and monitor KPIs for approval performance, compliance, and service standards

Skills:Decision makingStrategic thinkingLeadershipTeam developmentStakeholder communication

Company Brief

CARE Medical

Provides medical care and healthcare services in Saudi Arabia, likely including patient consultations, clinical support, and related healthcare offerings through its local medical brand and online presence.

Industry: Healthcare Providers

Headquarters: Riyadh, Saudi Arabia

Website

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CARE Medical

4 days ago

Approval Services Manager

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 22 hours agoStatus: Live

Job Summary

Location: Riyadh

Workplace: Onsite

Employment Type: Full time

Job Function: Solutions Engineering & Sales Engineering

Seniority: Manager level

Key Responsibilities

•Set department goals and objectives and cascade them to reporting sections while guiding achievement
•Oversee medical service request review and approval, ensuring clinical appropriateness and compliance with medical guidelines and regulatory requirements
•Supervise and manage the medical pre-authorization and approval team and provide direction for delegated responsibilities
•Ensure compliance with internal protocols, payer policies, and relevant healthcare regulations; train staff on clinical policies, coding, and documentation standards
•Resolve escalated cases and appeals with the medical review board or medical director; generate reports on trends, turnaround times, denial reasons, and compliance metrics

Key Requirements

•Leverage available information to make decisions in ambiguous situations within the approval function
•Adopt new ways of conducting BAU to create agility and move away from traditional approaches
•Drive strategic direction by monitoring developments in healthcare that impact section plans
•Build team capability by identifying learning opportunities and providing job enrichment
•Communicate and monitor KPIs for approval performance, compliance, and service standards

Skills:Decision makingStrategic thinkingLeadershipTeam developmentStakeholder communication

Company Brief

CARE Medical

Industry: Healthcare Providers

Headquarters: Riyadh, Saudi Arabia

Website