Case Manager - Healthcare

Job Overview

At Cure Link, we are seeking a dedicated Case Manager to oversee patient cases from initial referral through to resolution. This role plays an essential part in coordinating between healthcare providers, insurers, and strategic partners to deliver smooth and cost-effective healthcare services while enhancing the patient and member experience.

Key Duties

• Oversee medical cases assigned, ensuring progression from start to closure with timely updates and thorough documentation.
• Work closely with hospitals, healthcare professionals, insurance companies, and partners to coordinate care, negotiate treatment plans, and contribute to cost-saving measures.
• Evaluate medical and administrative records for compliance and facilitate smooth case advancement.
• Perform concurrent and retrospective utilization reviews to verify medical necessity, appropriate care levels, and adherence to stakeholder guidelines.
• Track turnaround times, maintain proactive communication with stakeholders, and keep accurate records within the CRM or case management systems.
• Identify and escalate complex cases as needed, maintaining a high level of service quality and satisfaction for members.

Candidate Profile and Requirements

• Possess a Bachelor of Medicine (MBBS) degree with clinical experience.
• At least four years' experience managing provider networks within the UAE healthcare sector.
• Minimum two years’ specialized case management experience in insurance or Third Party Administrator (TPA) environments.
• Certification or practical experience in medical coding systems such as ICD-10 CM, CPT, and DRG.
• Demonstrated negotiation, coordination, and stakeholder management skills geared towards controlling costs.
• Proficient in English communication; Arabic language skills are advantageous.
• Skilled in using CRM or case management software with excellent documentation and organizational capabilities.