د. محمود Weshah, Telemedicine,Revenue cycle Management ment Director

د. محمود Weshah

Telemedicine,Revenue cycle Management ment Director

Royal Commission Hospital

البلد
المملكة العربية السعودية - جدة
التعليم
ماجستير,
الخبرات
27 years, 0 أشهر

مشاركة سيرتي الذاتية

حظر المستخدم


الخبرة العملية

مجموع سنوات الخبرة :27 years, 0 أشهر

Telemedicine,Revenue cycle Management ment Director في Royal Commission Hospital
  • المملكة العربية السعودية - الجبيل
  • أشغل هذه الوظيفة منذ نوفمبر 2017
Director Of Business Development في Procare Hospital
  • المملكة العربية السعودية - الخبر
  • يوليو 2015 إلى نوفمبر 2019
Director of Medical Insurance في Saudi Enaya Cooperative Insurance Compnay
  • المملكة العربية السعودية - جدة
  • يوليو 2014 إلى يوليو 2015

• Manage sales & portfolio growth.
• Manage Preauthorization, Network and Claims departments.
• Manage Medical Underwriting & Re-Insurance Department.
• Manage CCHI communications and regulations.
• Manage Anti-Fraud and Medical Abuse Department.
• Manage Clinical Pathways Department.
• Manage Business Development Department.
• Manage Case Management team and utilization review...
• Manage Quality & Performance Improvement Department.
• Manage Hospital Excellence team.
• Manage Costing and Pricing Department.
• Manage ICD-10 Coding Department.
• Contribute to identifying the organization’s vision, mission and corporate strategy
• Contribute to developing the organization’s internal and external brands and market positioning Consolidate and review the business and manpower plans and budgets, and forward to the direct line manager for further approval
• Allocate and control the operational budget, approve significant decisions relating to expenditure
• Ensure the compliance of the division with Governance, Risk Management.
• Monitor staff achievements, perform periodic performance appraisals, and provide guidance or coaching to direct reports
• Review periodic performance reports for medical department.

• Collaborate with COO and top management to align plans and strategies for support, production and sales functions.
• Advise and approve the pricing of exceptional risks, in line with the corporate underwriting policy and the risk appetite expressed by the Board.
• Present and participate in Board and Management committees relating to risk, reporting and changes in the product portfolio
• Make quarterly review of business unit’s performance and discuss it in Business Management Committee.

Medical Insurance Manager في saad specialist hospital
  • المملكة العربية السعودية - الخبر
  • أبريل 2004 إلى يوليو 2014

Medical Insurance Manager

Director في arab orient insurance company (aoic)
  • الأردن - عمان
  • يناير 2000 إلى نوفمبر 2003

Director

Manager /Claims في MedNet
  • الأردن - عمان
  • يناير 1997 إلى يناير 2000

Manager /Claims

الخلفية التعليمية

ماجستير,
  • في chartered Insurance Institute Associate
  • أكتوبر 2013
ماجستير, Health Insurance Asoosciate
  • في Health Insurance Associate
  • يناير 2008
بكالوريوس, MD
  • في Volgograd Medical Academy
  • يونيو 1995

Specialties & Skills

Hospital Operations
Healthcare Management
Healthcare Consulting
Health Insurance
Claims Management
Computer
Leadership
Managed Care
Team Managemennt
Customer Care

اللغات

الانجليزية
متمرّس
العربية
متمرّس
الروسية
متمرّس

التدريب و الشهادات

Joint Commission Re-Accreditation Training (تدريب)
معهد التدريب:
Joint Commission Re-Accreditation Training
تاريخ الدورة:
June 2011
2007 CrestCom Training Saudi Arabia (تدريب)
معهد التدريب:
2007 CrestCom Training Saudi Arabia
تاريخ الدورة:
January 2007
Malcolm Baldriage Training Saudi Arabia (تدريب)
معهد التدريب:
Malcolm Baldriage Training Saudi Arabia
تاريخ الدورة:
March 2006
2008 3rd Healthcare insurance Forum Dubai (تدريب)
معهد التدريب:
2008 3rd Healthcare insurance Forum Dubai
تاريخ الدورة:
January 2008
2005 Joint Commission Accreditation Training Saudi Arabia (تدريب)
معهد التدريب:
2005 Joint Commission Accreditation Training Saudi Arabia
تاريخ الدورة:
May 2005