What you'll do
As a Medical Specialist, you will perform the following:
- Monitors and reports on Third Party Administrator (TPA) and Joint Venture key performance indicators (KPIs) as per terms and conditions of contracts.
- Reviews and assesses Third Party Administrator (TPA) and Joint Venture quality improvement and liability case reviews and compiles reports for Medical Joint Venture Coordination Department (MJVCD) and Saudi Aramco Organization executive management.
- Interprets and implements quality assurance standards.
- Meets regularly with TPA and JV quality improvement representatives to provide information, guidance and feedback on quality improvement activities.
- Reviews existing policies and procedures for adherence to quality standards.
- Reviews and evaluates patient medical records, applying quality assurance criteria.
- May oversee personnel engaged in quality assurance review of medical records.
What you need
As a successful candidate, you will have:
- Bachelor Degree in Healthcare is required.
- Master’s degree in Healthcare or related fields is preferred.
- Minimum of 12 years of experience in healthcare / including 5 years in Healthcare Quality Assurance/Improvement.
- Excellent proficiency in spoken and written English.
- Licensed and registered for Clinical Practice in Human Healhcare (Required).
- Certified Professional in Healthcare Quality (CPHQ) (Preferred).
Why this matters
This role is part of the Medical Review & Compliance Group under the Medical Services Management Department (MSMD). The Medical Specialist's primary role is to provide high-level consultations on medical cases, leading medical guidance and best practices. Spearhead quality improvement initiatives, and engage in innovative research and development.
