Head Of Pre-Authorization Department
BUPA Arabia
مجموع سنوات الخبرة :25 years, 10 أشهر
- Responsible for managing a team of primary care doctors and specialists.
- Responsible to manage and deliver on the commercial and service delivery targets set within a budget exceeding one billion riyal annually.
- Developed the supply delivery chain and service delivery module that lead towards achieving the best commercial and service results.
- Control and manage the benefit spend leading to reduction of providers monthly net billed, approved unit cost and referrals leading to achieve higher customer satisfaction levels while maintaining the control on the medical cost for targeted population.
- Implement the Quality Demarit Index for Approval, Rejections, Re-Work & Pending Approvals.
- Implemented Lvel 1 & Level 2 Structure within department to improve the quality decision makaing and responsiveness.
- Assess and evaluate, on a periodic basis, Individual and team performance progress against clear and defined objectives.
- Plan, coordinate and drive with the Operations Director and Medical Director the Pre-auth Strategy agenda and its delivery.
- Implemented the Step Ladder Referarl Process to manage the unit cost and network plans.
- Accountable for delivering adherence to regulation requirements for pre-authorisation adjudication and turn-round within the Team.
- Contributes to the budgeting and business planning process, and accountable for the control of operational costs within the Team’s area.
- Responsible for ensuring relevant pre-authorisation information is disseminated to management, providers, clients and members.
- Ensure consistency within the Team in the approval, full/part denial of treatment; ensuring thorough and robust decisions within the context of defined policy accepted guide-lines
- Meets providers when appropriate to ensure smooth implementation of pre-authorisation processes.
The entity is one of the world’s largest FMCG companies. The operations of Unilever Arabia span the entire Middle East, North Africa & Yemen.
Designation Chronology:
• Nov ‘07 - Present : Customer Service Operations & Excellence Manager - KSA Business Unit
• Jul ‘05 - Oct ’07: Customer Service Manager - Binzagr Unilever Factoory
• Aug ‘98 - Jun ’05: Sales Operations Supervisor
Achievements: - As Customer Service Operations & Excellence Manager - KSA Business Unit
• Recognized with the IT Excellence Award from Unilever Arabia.
• Managed the KSA distributor in terms of ordering forecast, fulfilment and stock coverage at 22 distributor warehouses with a total of 750 SKUs and annual turnover of SAR 1.9 bn.
• Performed demand management for the entire KSA BU that contributed to 50% of the GCC turnover.
• Led the SKU Complexity Reduction Plan across the North Africa Middle East.
• Drove the implementation of DRP replenishment and ICCFOT with local distributors from the central warehouse to 22 branches.
• Implemented OSA across all channels and spearheaded the implementation of secondary CCFOT across the KSA.
Responsibilities: - As Customer Service Leader - KSA Business Unit
• Driving the customer service agenda across the organization, formulating its vision and strategy in addition to fostering the growth of a service culture within key BU's and departments.
• Working in close cooperation with customers, supply chain personnel and other areas of operational interdependence within the company to improve customer service.
• Coordinating the Order to Delivery Process and administering the distributor stock management policy via distributors, consolidating, stock back to norm levels and consistently achieving envisaged CCFOT targets.
• Ensuring service delivery for distributors and the members of the S&OP process, monitoring all inputs and outputs, expediting forecasts, activity plans and monitoring appropriate adjustments made by the distributor.
• Confirming stock availability for planned promotions via distributor networks, managing exceptions during the month and reviewing of short term operational issues related to demand and supply.
• Spearheading the change management process, contributing to S&D reconciliation, fine tuning of BU processes and effectively administering the Order to Cash cycle, through the Customer Service Managers and indirect reports.
• Analyzing and implementing service level improvements recommended by distributors to key accounts, performing SWOT and ascertaining benchmarks of satisfaction.
• Establishing customer service agreements with distributors, managing sustainable customer relationships and oversaw all elements of the sales cycle to feed in to the customer service process.
Achievement:
• Managed the logistics network development, enhancement and operational execution from scratch to a point where it has become a key revenue contributor.
• Performed demand management for 6 main countries and 9 export countries.
Responsibilities:
• Oversaw all elements pertinent to customer service, handled order management through DRP, VMI and CIRS, conducted base line forecasts and promotions management to drive business objectives.
• Served as the local and country supply chain BU partner, managed promotions both centrally and locally.
• Marshaled demand execution functions for all factories and 3rd party distributor networks under purview for a period of 52 rolling weeks.
• Established KPIs, performed regular review, tracked discrepancies and reported the same to the management.
• Concentrated on areas of customer experience enhancement, service development and innovation management in addition to overseeing all network build up processes including run up and down, bleed in and delivery.
• Assumed responsibility for working capital management, ensured stock accuracy and control, SLOB and tracked business waste.
• Played a key role in driving many innovations in strategic warehousing solutions, service management, customer supply chain development and CCFOT service level improvement that increase company profitability.
• Controlled the S&OP HPC Supply Chain and made vital contributions to people and organization development in terms of process optimization recommendations, training and development.
Responsibilities:
• Supervised all sales operations, managed mass dealer contracts and consumer contracts and ensured that the envisaged business targets were being met regularly.
• Devised sales activity plans, performed analysis and audited trade stock to ascertain position to distribute it across key points of sale and managed POS sites country wide.
• Participated in all sales operational planning meeting with the managements of both the company and its distributors was instrumental in the field execution of all plans devised.
• Handled central promotions across the country and extended support to any areas that were lagging behind in terms of sales either due to a drop in demand or consumer confidence.
• Formulated stock liquidation plans for de-listed and old stocks thereby realizing much required liquidity and cash flow, allocated surpluses if any from the receipts of the same towards furthering sales initiatives.
• Visited all distributors in the network to eliminate any pending issues, grievances and updated them on the supply chain’s department's shipment plan.
• Analyzed and monitored network performance, focused on revamping and optimization of existing processes and rendered expertise on cost and resource innovations.
• Aligned country wide organizational brand marketing plans with customer business plans so as to achieve seamless integration and success gained by collective synergy of the customer and organization.
Key Professional Courses: • Pursuing CPIM Part I. • Review Course with Becker’s Conviser International Jeddah for CMA. • 2007: Master Planning & Resources (Module II) : Cleared