Ibrahim Osama

Responsible for overseeing the pre-authorizations team which includes; coaching, mentoring, developing of team members and monitor all authorization processes for meeting coordination of care, timeliness standards, cost-effectiveness, tracks and trends production of staff in order to reach a high-performance standard with ensuring clinical criteria are utilized and applied to determine medical necessity.

Supervising the chronic medications team responsible for verifying chronic medical conditions with providing support regarding decisions of related chronic medications based on policy coverage and medical necessity, along with monitoring team performance, efficiency, and quality.

Responsible for quality assurance and quality improvement at the level of the Patient Service Department by evaluating the departmental structure, processes & outcome measures including the team performance through KPIs & quality of the decisions taken in order to spot the deficiencies & areas of improvements for corrective actions.

Maintaining the authorization process of international policies and for the adherents with cross border coverage. Conducting knowledge with other team members by providing direct support & training sessions.

Handling the authorization process of the default portfolio for outpatient & inpatient requests based on policy coverage & medical necessity with maintaining maximum service quality.