Provider Engagement Officer

About the Role

We are hiring a Provider Engagement Officer for the Provider Relations team in Dubai. In this role, you will act as a case manager for SAICOHEALTH, helping coordinate medically appropriate, cost-conscious care that supports patient recovery while helping limit financial exposure for the insurer.

The role focuses on handling escalated cases from start to finish and maintaining effective working relationships with network physicians and hospital RCM teams. You will also act as a key contact for premium members who need guidance to suitable specialists and facilities for complex or high-value cases. A major part of the job involves building trusted connections with medical specialists and working closely with hospital RCM teams to simplify pre-authorizations, billing follow-ups, and complex discharge claims.

In addition, the role covers the remote Disease Management program, including reviewing patient-provided health records, assessing clinical status, delivering focused health education, and encouraging self-management.

Key Responsibilities

• Examine medical documentation for escalated cases, including high-cost, complex, and disputed claims, to confirm that requested care is clinically necessary and within policy coverage.
• Evaluate each escalation issue and resolve it by coordinating discussions with internal stakeholders and external providers.
• Identify practical, high-quality, and cost-efficient treatment options that can be proposed to members and providers to reduce unnecessary expense.
• Work with internal teams and providers to secure extra discounts on expensive claims and close single-case agreements with hospitals when needed.
• Develop and maintain strong working ties with hospital RCM teams, billing leads, and authorization units to address high-value claims and disputes through collaborative, evidence-based solutions.
• Partner with doctors, hospital case managers, discharge planners, and RCM staff to support safe and timely discharge to less costly care settings while keeping treatment quality intact and aligning with authorization timelines.
• Act as an accessible day-to-day point of contact for network physicians to handle administrative questions, escalations, changes in care, and process delays.
• Assess difficult or expensive patient cases and recommend the most suitable, effective, and economical doctors and facilities when required.
• Support patients with severe or complex conditions by coordinating care through the right network path, reducing delays and managing costs without compromising quality.
• Serve as the communication link between the patient, the treating doctor, and the insurer’s internal operations team.
• Support the remote Disease Management program by reviewing health records, identifying clinical status, providing education, and promoting self-management.

Requirements

• Bachelor’s degree in Medicine or Nursing (BSN).
• At least 5 years of clinical experience.
• Prior exposure to medical insurance, insurance case management, utilization review, or hospital-side RCM/billing will be considered an advantage.
• Medical background or coding certification is a plus.

Additional Information

This is a full-time role based in Dubai, United Arab Emirates, with a remote working arrangement.

The position is part of the Provider Relations department and is focused on balancing quality of care with cost management across complex member cases.