| Job Location | Cairo - Egypt |
| Education | MBBS(Medicine). |
| Salary | Not Mentioned |
| Industry | Medical / Healthcare / Diagnostics / Medical Devices |
| Functional Area | Not Mentioned |
For MedNet EgyptAs a member of Munich Re the MedNet Group is a leading TPA across the MEA region. We are currently seeking to hire a Senior Medical Reviewer Rule Engine with the following tasks and responsibilities:Your Job:? Ensuredelivering medical rules in the highest standards within the agreed targets.? Ensure the qualityof the medical rules delivered to My Detect is update Identificationof obstacles and implementations of solutions in liaison with stakeholders forthe project, operational managers,business partners and Vendors.? Liaise with claims department to ensurethe MRE performance is up to the highest standards.?Liaise with the respective Manager and HoOin deployment of any POC or pilot project for any prospective clients.? Testing of all raised technicaldevelopments in Rule engine as well as supporting systems, medical rule engineautomation.? Rule development for MRHT shield client.? Ensure that the rule maintenance and developmentprocess abide to the governance structure shared.? Development of rules as per trends andanalysis and implementation of rules are per operational requirements and inliaison with operational teams/committee.? Random audits of systems as well as datato ensure highest quality in functioning of the rule engine.Your Profile:? Medical Degree from a school recognizedby the WHO.? Medical knowledge and proved medicalpractice.? Minimum of 4 to 5 years experience inhealth insurance field.? Should have a track record of havingmanaged a team.? Experience in project management withsuccessful implementation of at least one project in health insurance relatedfield.? Clinical knowledge, including latestclinical guidelines.? Knowledge of medical coding ICD and CPT.? Industry knowledge related tolocal healthcare services system.? Strong leadership, planningand organizational skills.Munich Re not only stands for fairness with regard to its clients; it isalso an equal opportunities employer
Keyskills :
Senior Medical Reviewer - Rule Engine
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