Job detail

Job description

We have an urgent job opening in Qatar with one of our potential client, a US based healthcare benefits and insurance company.

¿ Only Female Nurses apply
¿ Only those who can speak native/Fluent ARABIC need to apply
¿ Freshers can also apply for the post of Care Management Nurse.

Background/Experience Desired
¿ 5-7 years of clinical experience.
¿ Management experience in a clinical setting desired. Experience in maternity ward/paedriatic is advantageous.


Education and Certification Requirements
Requires an current unrestrictive state licensure RN depending on state requirements, BSN desirable.

Additional Information (situational competencies, skills, work location requirements, etc.)
¿ Ability to communicate effectively with Providers, Members, and Staff & Upper Management in both an oral and written format.e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations.
¿ Ability to evaluate and interpret clinical and utilization data, identify areas of improvement, and focus on interventions to improve outcomes.
¿ Able to work with people in such a manner as to build high morale and group commitment to goals and objectives.
¿ Computer literacy and experience familiarity with Excel, MS Word, and web-based applications desired.

Nurse Manager:
- Over sees the implementation of Company¿s medical management services including but not limited to Inpatient Care Coordination/Discharge Planning/Case Management/Disease Management/Precertification and monitors daily performance to ensure business goals are met and compliance with company policies and procedures is maintained

- Liaison with other National programs to ensure successful implementation of a national initiative, may be accountable for cost and quality outcomes

- Protects the confidentiality of member information and adheres to company policies regarding confidentiality

- Evaluates clinical, financial, and medical management data and assigns resources accordingly to ensure cost effective quality outcomes

- Implements clinical policies & procedures and ensures compliance with NCQA, URAC, state and federal standards and mandates

- Provides input on clinical policies as they relate specifically to implementation of the medical services model

- Evaluates operational performance data (phone reports, nursing audits, etc) and implements procedural or training solutions to close gaps

- Provides direction and assistance in the review, selection, development and implementation of other vendor-contracted activities related to medical management programs

- Provides feedback to the business segments on benefit design and its integration into medical services unit

- Manage resources responsible for identification of members, development and implementation of care plans, enhancement of medical appropriateness and quality of care and monitoring, evaluating and documenting of care

¿ Management
- Prepares annual budget and monthly/quarterly budget status reporting

- Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams

- Manages teams of clinical and non clinical staff; conducts performance and compensation reviews, and implements staff development programs to encourage high performance

- Articulates performance expectation and team objectives while collecting and interpreting balanced measure to evaluate team performance

- Accountable for maintaining compliance with Human Resource policies and procedures and implements them at the employee level

- Ensures an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance

- Mentor Care Management Supervisors, providing leadership opportunities that enhance professional development, foster diversity, and sustain competitive advantage

-Sedentary work involving periods of sitting, talking, hearing, work requires visual acuity to perform close inspection of hand written and computer generated documents as well as a PC monitor. Typical office working environment.

-Involved in printing noe prescriptions, assist in billing, advise patients on tests to be conducted, medicnes to be taken, nutirion and more.

¿ Exhibits behaviors outlined in Care Management Nurse Manager Competencies

Salary open