Operations Manager
Al Ahly Medical Company, AMC
Total years of experience :12 years, 0 Months
AMC is a subsidiary of the National Bank Of Egypt, Established to hold and operate all medical projects
and investments of the NBE in the medical sector, It is one of the leading medical companies in Egypt,
AMC operate different Medical Lines of businesses as ( Establishing Polyclinics, Management and
Renovation of Hospitals, Medical TPA business ( Third Party Administration )
Job Duties and Responsibilities:
* Applying Company Goals and Objectives.
* Responsible for Account Management Division, Preauthorization Division, Customer Service
Division and Site Doctors Division.
* Allocating and selecting candidates for all Divisions
* Establish intra departmental policies and procedures.
* Planning for growth of the department and accordingly the company.
* Monitoring day to day divisions performance .
* Maintain company relation with customers and company strategic partners ( Insurance
companies, self management payers, .... etc)
* Controlling any diversion from the well established policies and procedures.
* Appraising and rewarding subordinates in each division from Medical Operations Dep.
* Preparing quarterly reports of performance to the CEO and Company Executive committee
* Liaises with Commercial Departments, IT Department and Network Management Department
to apply company goals
* Enhance and update the procedures as to maximize operational efficiency with in the allocated
budget.
* Preparing and controlling departmental Annual Budget, Man power plan, objectives and
Goals
* Arranging Monthly meetings with clients and strategic company partners.
AMC is a subsidiary of the National Bank Of Egypt, Established to hold and operate all medical projects and
investments of the NBE in the medical sector, It is one of the leading medical companies in Egypt, AMC
operate different Medical Lines of businesses as ( Establishing Polyclinics, Management and Renovation of
Hospitals, Medical TPAbusiness ( Third Party Administration )
Roles and Responsibilities :
* AMC central Preauthorization / Call center supervision.
* Issuing pre authorizations for laboratory services, radiology services, physiotherapy services,
medications and Inpatient Hospital admission cases.
* Follow up on Hospital admitted cases till discharge.
* Communication with the network of medical providers.
* Facilitate rendering of the medical service by patients.
* Control abuse of Medical Service and immediate reporting of fraud cases.
* Pre-employment Medical Checkup approvals and arrangements.
* Approval and issuing of sick leave documents
* Medical Network establishing and operation, Joined the team to operate the medical network of
providers, from initial communication till contract and final agreement.
* Responding to accounts/clients demands and concerns ( Account Management Unit ) Example
of these accounts are ( Egyptian Life Takaful Company ( Gulf Insurance Group ), Bavarian Auto
Group ( BMW importers and assemblers), TE Data, Orbit Showtime Network (OSN), National
Bank Of Egypt, ....etc
* Accounts In House/Site Doctors scheduling and Supervision.
* Chronic medications preauthorization
* Handle and Coordinate medical awareness campaigns
* Preparing reports of Utilization and consumptions.
* Preparing accounts annual renewals.
* Monitoring and Adjusting the company TPA software.
* Working with the Business Development team to innovate and enhance the medical service
rendered to the clients ( Patients and Accounts
Pre Authorizations Supervisor, working for the medical sector of the National Bank Of Egypt ( Serving 22, 000 Employee/Retiree)
Responsible for the following:
• Managing Emergency cases.
• Treating mild to moderate internal medicine cases.
• Filtering and referral of severe and advanced medical conditions that require consultants’ opinions.
• Issuing pre authorizations for laboratory services, radiology services, physiotherapy services, medications and Inpatient admission cases.
• Follow up on hospital admitted cases till discharge.
• Respond to patients inquiries in regards to conditions / Treatment
• Communications with all medical providers in the network.
• Facilitate the service for the patients.
• Control and report cases of abuse of the Medical Service.
• Pre-employment Check up approvals and arrangements.
• Approving and issuing of sick leave documents.
Responsible for the following:
• Managing Emergency cases (Site Clinic).
• Treating mild to moderate internal medicine cases (Site Clinic).
• Filtering and referral of severe and advanced medical conditions that require consultants’ opinions (Site Clinic).
• Issuing pre authorizations for laboratory services, radiology services, physiotherapy services, medications and Inpatient admission cases.
• Follow up on Hospital admitted cases till discharge.
• Communications with all medical providers contracted in the network.
• Facilitate the service for the patients.
• Control abuse of Medical Service.
• Pre-employment Check up approvals and arrangements.
• Approving and issuing of sick leave documents.
