Chief Operating Officer
ElAraby Hospital
Total years of experience :22 years, 0 Months
All COO duties & responsibilities
& RCM manager.
Determine and formulate policies and provide the overall direction of Marketing Strategy. Plan, direct, or coordinate Marketing activities at the highest level of management with the help of subordinate executives and staff managers.
•Develop pricing strategies, balancing firm objectives and customer satisfaction.
•Identify, develop, and evaluate marketing strategy, based on knowledge of establishment objectives, market characteristics, and cost and markup factors.
•Evaluate the financial aspects of service development, such as budgets, expenditures, research and development appropriations, and return-on-investment and profit-loss projections.
•Formulate, direct and coordinate marketing activities and policies to promote services, working with advertising and promotion managers.
•Direct the hiring, training, and performance evaluations of marketing staff and their daily activities.
•Consult with service development personnel on service specifications.
•Compile lists describing product or service offerings.
•Confer with board members, organization officials, and staff members to discuss issues, coordinate activities, and resolve problems.
•Analyze operations to evaluate performance of a company and its staff in meeting objectives, and to determine areas of potential cost reduction, program improvement, or policy change.
•Prepare budgets for approval, including those for funding and implementation of programs.
•Direct and coordinate activities of businesses or departments concerned with pricing, and/or distribution of hospital services.
•Negotiate or approve contracts and agreements with suppliers, distributors, federal and state agencies, and other organizational entities.
•Review reports submitted by staff members in order to recommend approval or to suggest changes.
- Dealing with all insurance companies for all issues related to contracts, medical rejections, price lists, volume of business.
-Marketing campaigns.
-Competitor analysis
As a CMO ( medical affairs chief ) I’m monitoring the medical services in the hospital and reports to the CEO, with any other assignment given by him, and participation in all activities related to the PI department ( Performance Improvement ), updating hospital policies, clinical guidelines & all accreditation activities ..
And assigned to replace the hospital CEO (Chief Medical Services & PI) duties in his absence.
Offering clinical guidance and support to staff and medical team members. Staying current with new modes of healthcare delivery and innovating business and healthcare strategies. Ensuring accreditation of facility and team members. Building relationships with the community for financial and clinical partnerships. Overseeing quality of services, interactions, and treatments. Developing new economic models for facility operations. Reports regularly to the Chief Medical Officer about the hospital services. Review daily reports from various departments. Participate in improving the quality of service. Provide medical services as required and conduct daily rounds in different departments. Continually monitor the professional performance and ethical behavior of Medical staff. Evaluate the service in different departments and give suggestions to improve it. Coordinate with the Head of Departments to prepare the monthly on call schedule
JCI Accreditation activities:
- MOI Chapter Leader
- AOP Co Chapter Leader
- PCI Co Chapter Leader
- Hospital wide committees involvement
Hospital wide Committee Position
1 Hospital Management Member
2 Medical Council Chairman
3 Utilization Management Chairman
4 Claim Rejection Management Chairman
5 PI PS Council Member
6 Accreditation Steering Committee Member
7 Infection Prevention & Control Member
8 Credentialing & Privileging Member
9 Pharmacy & Therapeutics Member
10 Mortality & Morbidity Member
11 Environment of Care Member
12 Management of Information MOI Medical Review Committee Member
13 Ethics & Patient Rights Co Chairman
14 Peer Review Member
15 OR (Surgical) Co Chairman
16 CPR (Code Blue & RRT) Member
17 Blood Utilization Co Chairman
18 Tissue Review Member
19 Education & PTC Member
20 Moderate Sedation & Pain Management
Member
21 Disaster Management Member
22 Customer Satisfaction Member
23 Antibiotic Stewardship Program Member
As a Business Development Manager I'm responsible for generating new business from the Broker sector and meeting production targets by introducing ACE product range to existing and new producers.
Responsibilities:
• Gaining new business through brokers by identifying and exploiting opportunities in the local market.
• Developing and maintaining good working relationships with clients, primarily insurance brokers and direct clients.
• Introducing new products and promoting them through regular visits and frequent communication with clients.
• Increasing profitability of existing product lines by encouraging clients to use added value services wherever possible;
• Consulting and promoting the most effective cover for a particular need, taking a number of factors into account;
• Delivering good customer service by responding swiftly to queries and concerns from clients, brokers and third parties.
• Maintaining detailed knowledge of new and existing products by liaising with colleagues;
• Ensuring credibility with clients by maintaining detailed knowledge of current market conditions and competitors' products;
• Monitoring and reporting on performance against agreed sales targets, sometimes including monitoring the performance of other sales staff.
• Working with underwriters to amend policies where necessary in order to meet client demand.
Key accountabilities
• Establish and build new relationships with existing and potential producers that have prospective business that meets the companies underwriting criteria
• Maintain existing relationships in order to protect existing books of business
• Develop an in depth understanding of ACE products
• Co-ordinate any marketing campaigns to prospects
• Conduct broker training and presentations.
• Assist brokers with product and business queries
• Demonstrate business planning skills to achieve visitation & sales targets
• directing, coordinating and administering medical and non-medical resources, facilities and services
• liaising with clerical, medical and professional staff at all levels
• developing services and implementing changes
• recruiting staff
• attending meetings
• writing reports
• managing budgets
• dealing with complaints or problems
• ensuring services meet national standards
• Leads and manages the claim operations and overall performance of the Claims Department. Builds and develops team into cohesive, high performing unit.
• Ensures compliance in accordance with all regulatory and contractual requirements.
• Motivates Claims Department supervisor and staff and takes necessary steps to ensure outstanding service is provided at all times, to both internal and external customers.
• Work diligently to ensure accurate and timely claims payment and associated documentation (remits.)
• Identifies, implements, monitors and applies appropriate performance metrics aligned with and supportive of Prime Health organizational goals and objectives.
• Ensures that all claims are accurately and efficiently processed in a timely manner and documented in accordance with Prime Health policies, processes and procedures.
• Ensures timely, accurate and thorough responses are given to all provider dispute requests and inquiries regarding claims status and other claims information.
• Ensures effective communication cross-departmentally.
• Interacts with Care Management and Utilization Management as it relates to the claims operation, e.g. pre-authorizations, retro-authorizations, etc.
• Monitor and evaluate staff performance, attendance and punctuality. Provide ongoing, constructive, objective performance feedback. Take corrective action in a timely manner when inappropriate behavior and/or performance related problems arise in order to foster improved performance and/or early problem resolution.
• Oversees and helps facilitate the training of claims department staff to ensure each individual develops and enhances the technical and soft skills necessary to perform and develop mastery of their respective job duties and responsibilities and progress.
• Ensures the timely auditing of delegated medical group claims operations.
• Recruit, hire and train new staff as needed. Take steps to distinguish and ensure acknowledgment and retention of high performers.
• Direct and manage internal or interdepartmental projects.
• Lead department participation in all regulatory and financial audits, including resolution of audit findings.
• Define internal department audit requirements based on results on monthly random audit, Contract and Compliance audits and external audits.
- Conducting Prime Health Presentations to the Top Clients
- Regular meetings with the Clients & Providers .
- Responsible for the final approvals of the medical reconciliation with the providers .
- Involving in updating of The Company Contract .
- Responsible for the following departments:
- Providers Network relationship department
- Medical Audit Department
- Cash Reimbursement Department
- Medical Approvals Department
- Claims processing Department
*Planning & Forecasting :
-Establishes periodic budgets for the hospital-wide operations and extra-curricular activities necessary to enhance the hospital image and achievements.
-Plans other activities contributory to the goals, mission, and vision.
-Forecast/projects budgets and estimated revenue on the hospital operations.
*Organizes all materials, facilities, personnel and other resources necessary to run the hospital including medical needs.
*Supervises all hospital-wide activities.
*Monitors & Controlling
hospital-wide activities ensuring high quality services, correction of errors to avoid repetition of the same mistakes.
- Implements rules and regulations; policies and procedures making sure implementation is effectively carried out by all staff.
- Utilizes effectively all the resources .
- Liaises with higher Management; Construction and other related Departments.
- Establishes a good system for the careful, economical, and efficient utilization of resources.
- Develops adequate financial controls to keep-up accurate records and prevents misappropriations of hospital funds, facilities, and properties.
Approves purchases of equipment and materials looking after supporting feasibility studies to ensure their proper use and reach revenue expected.
Leads to prevent and cope-up with fire, theft, and unexpected disasters within the hospital premises.
Decision-Making:*
- Makes unbiased decisions non-medical or medical in coordination with Chief of Medical Operations (CMO) for the benefit of the whole organization (for both employer and employees).
- Takes decision for any administrative issues in consultation with the Governing Body for advisory.
- Implements hospital compliance of all government rules and regulations, legal and ethical issues, and other statutory requirements in collaboration with Government and Legal Affairs Directorates.
- Recommends salary structure, other staff benefits, costs and service fees to the higher management.
Determine and formulate policies and provide the overall direction of Marketing Strategy. Plan, direct, or coordinate Marketing activities at the highest level of management with the help of subordinate executives and staff managers.
•Develop pricing strategies, balancing firm objectives and customer satisfaction.
•Identify, develop, and evaluate marketing strategy, based on knowledge of establishment objectives, market characteristics, and cost and markup factors.
•Evaluate the financial aspects of service development, such as budgets, expenditures, research and development appropriations, and return-on-investment and profit-loss projections.
•Formulate, direct and coordinate marketing activities and policies to promote services, working with advertising and promotion managers.
•Direct the hiring, training, and performance evaluations of marketing staff and their daily activities.
•Consult with service development personnel on service specifications.
•Compile lists describing product or service offerings.
•Confer with board members, organization officials, and staff members to discuss issues, coordinate activities, and resolve problems.
•Analyze operations to evaluate performance of a company and its staff in meeting objectives, and to determine areas of potential cost reduction, program improvement, or policy change.
•Prepare budgets for approval, including those for funding and implementation of programs.
•Direct and coordinate activities of businesses or departments concerned with pricing, and/or distribution of hospital services.
•Negotiate or approve contracts and agreements with suppliers, distributors, federal and state agencies, and other organizational entities.
•Review reports submitted by staff members in order to recommend approval or to suggest changes.
- Dealing with all insurance companies for all issues related to contracts, medical rejections, price lists, volume of business.
-Marketing campaigns.
-Competitor analysis
--Acting Polyclinics Director for 3 months.
-Verifying that applied rates are compatible with signed agreements
-Verifying that treatment provided is justifiable medically
- Processing Claims for payment
-Support the providers network
-Supervise field doctors
- training
-Marketing
Responsibilities:
- Assisting in Ministry’s information system analysis data collection & Web pages designing .
- Organizing the (IGS) projects meetings & setting the Work Plan Agenda .
- Participating in “The Children Vaccination Cards Project”.
- Periodical inspection on the Health Care Units in different Governance through out Egypt, checking the Children Vaccination Cards & following up on the work done by Physician in the units.
- Organizing different Health Conferences, Summits & Seminars
- Preparing of a research study on how to design & implement the Information System in Ministry of Health hospitals, and how to connect all these hospitals through a Unified Information System
Learn to think strategically about the rapidly growing and competitive healthcare sector and what you must excel in to succeed Develop deep insights into the healthcare marketplace, the needs and wants of healthcare consumers and the behaviour of your competitors Transform performance for your department, clinic or hospital through better talent management Learn to calculate the true cost of patient care and use this information to deliver sustained profitability and growth Lead and manage change more confidently, more effectively and more successfully. - Strategy and Strategic Development in Healthcare – Strategic Healthcare Marketing – Managing People and Performance in Healthcare – Managing Financial Resources in Healthcare – Leadership and Change in High Performing Healthcare Organisations
This is a postgraduate diploma accredited by the Supreme Council of Universities. The diploma encompasses six courses covering the following areas: management functions, human resource strategies, marketing, information systems, finance and accounting, and total quality management (improving medical performance).