Job Description

About Us:

We are seeking ambitious individuals who share our values and passion for making a positive impact on people's lives around the world. If you are looking for a career that challenges and inspires you, you've come to the right place.

About You:

You are an experienced Medical Professional who can handle a large case load, multitask, and meet tight deadlines. You thrive in a fast-paced, 24/7 team environment and will provide excellent customer service via email, phone, and fax.

You will have the ability to demonstrate in-depth understanding of the case management process and work well with other departments to troubleshoot and resolve issues should they arise. You must be willing to work rotational shifts, including days, evenings, nights, weekends, and statutory holidays. You will also be part of an on-call rotation to handle situations outside of regular business hours.

You will be the primary point of contact for a specialized case and claims management team requiring both medical and non-medical expertise. You will guide and provide direction to other Clinical Case Managers, Intake Specialists, and Claims Examiners, utilizing your clinical knowledge by performing medical reviews and validations for Claims.

You will be responsible for the management of their case load, which entails medical management and cost containment principles. They will also perform other tasks in assistance, such as coordinating and booking appointments, finding health care providers, and making travel arrangements. You will also act as a liaison between the client, patient, and service providers. The role has an after-hours component that requires the Case Manager to be on-call for any calls and medical emergencies that may arise outside of standard business hours of which will require immediate medical review and action.

In this role, you’ll get to experience:

• Medically validate cases and determine the necessity
• Summarize medical information in a clear and concise manner
• Manage a case load of patients in all phases of their treatment course until discharge and return home
• Provide assistance services to travelling members
• Communicate relevant information to all key stakeholders promptly to achieve the best patient outcomes in a GDPR and PIPEDA-compliant environment
• Weekly rounds or case notification reporting to clients
• Facilitate commercial or medevac repatriations
• Coordinate care and arrange billing with various service providers
• Effectively communicate and document all interactions in the case management database
• Act as the liaison between the patient, family members, multidisciplinary teams, service providers, and the client
• Confirm coverage details with service providers and members
• Provide a clinical opinion and participate in the patient’s plan of care
• Be available for rotational shifts on days, evenings, nights, weekends, and statutory holidays
• Participate in an on-call rotation servicing clients outside of standard business hours
• Communicate with health care providers to coordinate appointments for patients
• Other duties as assigned by the KSA Operations Manager, Case Management Supervisor, and Director - Program Delivery

What you bring:

• BSc or Diploma in Nursing, Doctor of Medicine, or the equivalent.
• Currently licensed as either a doctor or a Nurse in good standing.
• Fluent in English and Arabic (verbal and written) - GCC Dialect
• Minimum 3 years’ experience working in the Kingdom of Saudi Arabia or an Arabic-speaking position, and minimum 2 years of Case Management experience
• Solid clinical skills in a variety of disciplines such as oncology, transplant, and orthopedics
• Intermediate level of experience in the Microsoft Office Suite
• Superior time management skills
• Ability to work well both independently and as part of a team
• Critical thinking and decision-making skills
• Ability to work in a fast-paced and dynamic environment

Preferred Skills

• Prior experience managing cases for an International Patient Program.
• Previous experience in travel, major medical, or expat insurance within a TPA environment

Additional Notes

• This position requires availability for a shift that will cover the European Union’s business hours of operation. A rotational shift to satisfy business operational needs, including days and evenings, is required, including holidays. Overtime is required on an occasional basis.
• On-call rotation is at least 1 week every month

What’s in it for you:

• Hybrid work environment
• Excellent health benefits
• Employee assistance program
• Wellness account
• RRSP matching
• Minimum 3 weeks’ vacation
• Generous amount of sick and flex days
• Tuition reimbursement program
• Opportunities to learn new skills, grow, and move into different roles
• A work environment that embraces diversity and promotes inclusivity.
• Supportive leadership prioritizes your success and cares about your well-being.
• A growth trajectory designed to expand vertically and horizontally, providing opportunities to pursue your passions and acquire new skills.

If you don’t meet every qualification listed, we encourage you to apply. At MSH Americas, we value diverse backgrounds, perspectives, and experiences. We are proud to be an equal opportunity employer committed to fostering an inclusive and supportive environment. If you require reasonable accommodations at any stage of the application process, our Human Resources team is here to support you.

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