Job Description

Job Title CASE COORDINATION SPECIALIST.

Job Family

Function CORP (SME: CFO-CPHO)

Job Code 30009336

Reports to Job Business Unit Lead

Summary The Case Coordination Specialist oversees complex patient cases, advises on issues with internal and external stakeholders and evaluates appropriateness of advanced levels of care utilizing evidence.-based tools to enhance the patient experience, ensure patient access and optimize cost.-effective outcomes.

Strategic Roles & Responsibilities % 10

Strategic Roles & Responsibilities

Participate in regular team meetings to discuss Case progress share updates and identify areas for Process Improvement Coordinate with internal and external stakeholders to ensure seamless communication and efficient Case resolution

Operational Roles & Responsibilities % 90

Operational Roles & Responsibilities

Evaluate standard to complex requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidencebased tools to ensure patients receive quality costeffective care Coordinate patient care to meet the individuals and their familys needs and ensure patient safety quality of care and costeffective outcomes Coordinate processing of standard case review and documentation including logging tracking and resolution following established protocols and within defined service level agreements SLAs or provider contracts Assist in maintaining uptodate patient documentation and periodic reporting ensuring information completed efficiently and accurately and is readily accessible for review and audits Support the continuous patient care access and identifying and escalating anomalies to avoid patient care interruptions

Minimum Education Required BacheloraEUR(TM)s Degree in Nursing or Medicine.

Professional Certifications Required Refer to applicable JD Addendum

Years of Experience 9.-12 years of experience in relevant field

Languages English:Fully Proficient ; Arabic:Not Required

Functional Competencies

Due Diligence Audit Reporting Data Collection

Core Competencies

Excellence Integrity Accountability Cybersecurity Person-Centered Care

Acknowledgement Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Addendum Title No

Supplemental Work/Experience/Education Information N/A

Addendum Description N/A