Senior Manager of Clinical Operations
My Clinic - KSA
Total years of experience :20 years, 4 Months
Leading Clinical Operations, “My Clinic” Jeddah including:
* Home Care Service Department:
• Home-Based Lab
• Home-Based Vaccination
• Medication Refill Doctors & Medication Delivery
• Home Medical Care Nursing, Doctors & Physiotherapy
* My E-Clinic Application: audio-video application for Tele-consultation
* Corporate and Health Checks Department:
Dedicated unit for health checks
• Corporate Pre-employment checks
• Corporate Annual Health Check ups
• Executive & VIP Health Check ups
* In-house Clinics:
Lead a chain of in-house Clinics located at corporate bodies to provide a comprehensive scope of Occupational medicine, safety & first aid /emergency management.
* Business Development:
Play a crucial role in business expansion and is part of the BD committee including the CEO & the board of directors.
▪ Clinical operation lead of My Clinic - Branch 2 - Alsafa
▪ Clinical commissioning lead in expansion projects
o Clinical Design, Set up and MOH licensing of MC1 - 2015
o Clinical Design, Set up and MOH licensing of MC2 - 2021
▪ On Site Clinics:
o Lead a chain of on-site Clinics located at corporate bodies to provide a
comprehensive scope of medical, occupational, safety & first aid
/emergency management.
▪ Corporate and Health Checks Unit:
o Design, Establish & Manage a process for Delivery of Medical Care
through a dedicated unit for health checks including but not limited to:
Pre-employment checks, Annual Health Check-ups, Executive & VIP
Health Check-ups.
▪ Chronic Disease Management (CDM ) Doctor Team
o Tele consultations, Coaching, Medication refill, Delivery & home
Labs
▪ Telemedicine Service:
o My Clinic application audio-visual consultation with patients
o Establish & Manage a Healthcare Operations process that re-engages
patients in clinical services at “My Clinic” and ensures continuity of care
▪ Home Health Care Services Unit:
o Lead the Home Care team to promote, support and enhance “My Clinic”
service proposition with patients & their families beyond the point of
care.
▪ Population health management program (Diabetes, Hypertension,
Dyslipidaemia).
▪ Business development clinical lead
“My Clinic” Jeddah is our first Flagship Centre in KSA supported and licensed by Bupa Global Network.
Being one of Bupa International Network of Healthcare providers we adopt a holistic approach to our patient’s health and wellbeing by providing multi-disciplinary healthcare.
Laid out over 7000 sqm, 7 Floors with more than 40 Consulting Rooms, a fully-fledged Imaging Department, Laboratory, Physiotherapy, Day Case Surgery Theater, ER Unit and a Pharmacy.
* Clinical Operations:
• Oversees & Manages all Doctors, Imaging, Laboratory, ER & Physiotherapy Operations.
• Leads on clinical operations with 3rd Party providers of care: Group practices & Hospitals
• Ensure all equipment, supplies, clinical processes, clinical manpower and service processes are clearly in place in the above areas.
• Ensure that clinical operation is fully run and integrated with the service part, Clinical and Service processes are fully implemented.
• Ensure that clinical standards and patient safety standards are met.
• Update to CEO and MD on all related clinical operation activities.
• Sits in the customer service committee as one of the top 3 leaders responsible on Service Design and Operation.
* Clinical Service Planning:
• Play a crucial role in planning and sits in the planning committee with CEO & Directors.
• Responsible for efficient scheduling of medical services providing a comprehensive scope of service. Owns Equipment capacity and utilization & Doctors and specialties utilization.
• Leads on Doctor, Nurses & Allied healthcare professionals’ performance monitoring and reporting
* Medical Teams Lead & Representative:
• Represent voice of Medical Teams at Bupa Clinics by gaining a deep understanding of end users’ clinical workflow and operational requirements.
• Work with operations & services teams to ensure effective service delivery. The link between the Operations, Service & Medical Teams. Serves as a liaison between medical staff and administration.
• Focus on the provision of professional support and leadership to ensure the effective, safe and efficient operation of all clinical/medical services
• Promotes active engagement with front line clinical staff (Doctors, Nurses, and allied health professionals) in Bupa Clinics Development
• Accountable for consistency across the system as changes in process, tools, and overall practices are developed, ensuring a focus on continued system integration and overall system benefit.
• leads the Focus Improvement in all the above areas.
• Externally oriented to bring in best practices on operation and innovations from Bupa internationally & builds our clinical network with Bupa globally.
* Centres of Excellence, Clinical delivery models and Product development:
• Identify clinical and healthcare benefits by designing and executing Clinical Delivery Models; translate results into a compelling Care value proposition that resonates with the clinical end user.
• Provide ongoing and actionable feedback to the Medical Teams and continuously improve the design of the Models/Propositions.
• Leads Clinical Innovation, system implementation & automation of the care delivery model e.g. Diabetes, ANC
• Lead a team of coordinators, nurses & doctors across the Bupa clinics to achieve the highest rates of compliance & engagement with healthcare services.
• Leads continuity of care initiatives across the organization by designing & implementing proactive reach out programs for the patients.
* Service Excellence strategy at Bupa Clinics. Responsible for establishing the baseline for the patient/customer experience .Interpreting patient/customer insights, process analysis, business analysis, process mapping and process improvement execution. Establish key areas of focus for improved patient experience; drive focus, prioritization, execution and accountability for fixing the largest/most impactful patient experience gaps.Building a reliable, then differentiated patient experience in Bupa Clinics. Manages evolution of patient/customer journey map over time. Defines, develops and oversees implementation of a portfolio of initiatives designed to improve the patient experience. Partners to create implement and evolve the Project road map.
*Develop the Clinical Excellence strategy ensuring the medical teams at Bupa Clinics are competent in the delivery of all quality standards, procedures and policies. Ensure national standards are met and best clinical practice is cascaded and evaluated throughout the team. Works cross-functionally with a team of consultants in different specialties to establish the clinical strategy in order to deliver against the overall company strategy.That includes but is not limited to setting & designing the Scope of Medical Services, Space allocation, Clinical Implementation Protocols, Equipment & Man power requirements at Bupa Clinics.
Selected Accomplishments:
• Designed Customer journey & identified major touch points & key activities.
• Identified areas of service differentiation throughout the journey in a Differentiation Delivery System.
• Designed Processes, KPIs, identified people & technology requirements, also risks & challenges.
• Led mapping exercises & developed the Bupa Clinic Differentiation Delivery System plan.
• Medical calibers Recruiting Process, Plan & Talent shortlisting
• Customize clinical pathways & map to Service Proposition delivery model
Responsible for the execution and delivery of the Bupa Arabia quality control and improvement program in Preauthorization, Claims, Membership & Provider Relation Processes. Including service and operational, in alignment with international patient safety goals, accreditation standards and insurance policy parameters.
Defining quality procedures in conjunction with Operations & Medical Teams
Involved in complaint resolution and recovery process. Key in focus improvement projects and medical across the organization.
Compiles statistical data and writes narrative reports summarizing medical quality assurance findings. Maintains a database for all quality & performance indicators and updates this.
Responsible for achieving a collaborative working environment between other departments performing quality-assurance, management & improvement activities.
Monitoring of unusual occurrences/variations; conducts root cause analysis & prepares action-plans & recommendations.
Maintain training plans for different departments, in alignment with the business.
Assists departments with the coordination of audit information, and recommend appropriate data-gathering mechanisms, procedures, etc.
Monitors trends, identifies triggers and benchmarks data
Selected Accomplishments:
Delivered quality models to improve and ensure clinical excellence in healthcare.
Delivered quality models to assess service quality at the Claims and Provider Relations level.
Identify areas of improvement to engage both internal and external stakeholders in the service strategy.
Lead a team of medical doctors to collaboratively improve our medical decision making.
Identify innovative service opportunities.
Defining quality procedures in conjunction with Operations & Medical Teams
Involved in complaint resolution and recovery process. Key in focus improvement projects and medical across the organization.
Responsible for achieving a collaborative working environment between other departments performing quality-assurance, management & improvement activities.
Monitoring of unusual occurrences/variations; conducts root cause analysis & prepares action-plans & recommendations.
Monitors trends, identifies triggers and benchmarks data
Selected Accomplishments:
Delivered quality models to improve and ensure clinical excellence in healthcare
Identify areas of improvement to engage both internal and external stakeholders in the service strategy
Lead a team of medical doctors to collaboratively improve our medical decision making
Identify innovative service opportunities
Bupa Arabia, Jeddah, KSA 2011- 2012
Quality Control Auditor/Doctor; TQM & Service Strategy
To maintain the quality of both outpatient and inpatient adjudication by assuring that all process are up to the quality
control measures developed in Pre-Authorization.
Coordinate & collaborate with all core medical departments; including but not limited to Pre-Auth, HAD, Customer Service, Claims & Provider Relations
Reporting on a consistent basis a weekly scorecard with the quality control audit results, for both medical as well as policy adjudications.
Maintain member & provider satisfaction while implementing processes/solutions.
Maintain training plans for Pre-Authorization, in alignment with the business.
Selects specific topics for review, such as complicated procedures, drugs, high volume cases, high risk cases, high value cases, or other factors
Bupa Arabia, Jeddah, KSA 2009 - 2011
Senior Medical Officer; Pre-authorization
Ensure medical cost control through managing benefit spend, making sure that decisions are within defined policy
accepted guidelines and high quality medical standards.
Recognize and fight abuse, mistreatment, overtreatment, Fraud and anti-selection in all its forms and report such behaviour according to guidelines.
Maintain full cooperation with roving doctors, sales and CS team to ensure that other department can justify, defend and convince customers that the medical decision was according to contract rules and to the best medical practice.
Working constantly to up-grade knowledge and experience in order to meet challenges in all aspects of work.
Offer help and training to new colleagues.
Provide positive feedback and take ownership in finding solutions.
Reviewing and admitting patients in the weekly outpatients’ clinic.
Managing Operation Theater patient lists
Conduct and review pre and postoperative care of the patients on the ward
Nephrology & Dialysis center that receiving about 50 patients per day.
Services include clinical examinations, investigations, and treatment including haemodialysis.
Being the Assistant Manager of the center, my responsibilities also included administrative managing.
Cairo University Hospital is one of the largest and most prestigious university hospitals in the Middle East and it has over 3, 000 beds. The Hospital is well equipped with several investigative and therapeutic medical equipment. As an intern, I had the opportunity to work under the direct supervision of experienced Professors and Consultants in the Cairo University Hospitals, which I have found extremely useful. I attended six rotations, two months as follows:
Emergency Medicine and Anesthesia Departments
Surgical department
Pediatrics Department
Obstetrics & Gynecology Department
Internal Medicine Department
Ophthalmology and Surgical Oncology
M.B., B.Ch. of Medicine & surgery June 2004 (Grade: Very good with Honors) Kasr El Einy Medical School, Faculty of Medicine, Cairo University, Cairo, Egypt.