20 Clinical Operations jobs in Saudi Arabia
Manager - Clinical Operations
Posted 13 days ago
Job Viewed
Job Description
The Manager Clinical Operations Manager is responsible for overseeing the daily operations of a clinical operations and digital clinic that provides in-person care, Telehealth and remote healthcare services. This role is vital in ensuring that clinical operations run smoothly and efficiently, delivering high-quality patient care while maintaining high levels of member satisfaction. The manager will monitor service delivery, address operational challenges, and support the strategic expansion of digital clinic services
Clinical Operations Management
- Oversee all operations and clinical operations and operations of digital clinic to ensure seamless service delivery.
- Develop and implement standard operating procedures (SOPs) for clinical workflows, ensuring compliance with healthcare regulations and best practices.
- Monitor clinical performance metrics, including patient wait times, consultation durations, and clinician productivity.
- Conduct regular audits of clinical processes to identify areas for improvement
Post-Consultation Service Monitoring
- Ensure the timely completion of all post-consultation services, including follow-up appointments, lab orders, and medications.
- Implement a tracking system for all post-consultation activities, ensuring that follow-ups are scheduled and completed as needed.
- Communicate with clinical staff or stakeholders to verify that all recommended services are being delivered promptly.
- Develop a feedback loop for all issues related to services and complaints for in-person clinic and digital clinic
Member Satisfaction Management
- Address and resolve any issues related to member satisfaction and service delivery.
- Review patient satisfaction surveys to gather feedback on their experiences with the clinical operations, clinical care and digital clinic and address all issues.
- Analyze survey results and patient feedback to identify trends, strengths, and areas for improvement.
- Implement changes based on feedback and communicate these changes to both staff and patients.
- Facilitate a customer service training program for staff to enhance patient interactions and service quality
Operational Reporting and Analysis
- Prepare daily reports on completed consultations, ordered labs, and medications to monitor clinic performance.
- Utilize data management software to collect and analyze operational data, ensuring accuracy and relevance.
- Generate daily, weekly, and monthly performance reports highlighting key metrics and trends.
- Present findings to the management team, providing actionable insights and recommendations for improvement
Scheduling and Resource Management
- Ensure clinician schedules are prepared and open well in advance, addressing any blockages quickly.
- Collaborate with clinical staff to optimize scheduling based on patient demand, clinician availability, and service types.
- Monitor booking trends and adjust schedules proactively to minimize patient wait times and maximize appointment availability.
- Resolve scheduling conflicts and communicate changes to Healthcare Center promptly.
- Ensure proper communications with different teams
Medical Operations & Evidence Generation Specialist
Posted 2 days ago
Job Viewed
Job Description
Company Description
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas – immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at . Follow @abbvie onX ,Facebook ,Instagram ,YouTube ,LinkedIn andTik Tok .
Job Description
DEPARTMENT FUNCTION AND OBJECTIVE
The local Medical Operations & Evidence Generation Team based in the Medical Department of the Saudi Affiliate (Medical Director, Medical Operations & Evidence Generation Manager, Medical Operations & Evidence Generation Specialist) has the overall responsibility for the development and execution of the Affiliate Medical Operations & Evidence Generation strategic plans.
PRIMARY FUNCTION
- To provide set-up, coordination, and execution of centrally or locally sponsored, international, and local Non-Interventional Studies (NIS) as a member of the Medical Department of AbbVie in the Affiliate.
- Reporting to the Medical Operations and Evidence Generation Manager, this position represents the country/region expertise for post-marketing observational and other non-interventional studies. The position provides operational advice/guidance to the Affiliate Medical Affairs organization for multi-country or local projects.
- Work with the Medical Director to ensure that the Medical Department delivers value to the affiliate, patients, and the medical community through excellence in the planning and execution of medical projects and activities in preparation for launches (“Launch Readiness”), leadership of the Gap Assessment and medical anchors of the Brand Plans, in-field medical team effectiveness, evidence generation, medical education, and all medical initiatives. Ensure the quality of processes and compliance in the Medical Team through the development and control of procedures and documentation, conducting audits of service providers, conducting internal audits, in accordance with local regulations and global requirements of AbbVie.
MAJOR DUTIES AND RESPONSIBILITIES
Clinical Research and Evidence Generation
- To lead the development and execution of different types of evidence generation: non-interventional studies, Pharmacoeconomics studies, epidemiological studies, Real World Evidence in collaboration with internal stakeholders including but not limited to Medical and Market access.
- To ensure the development of the affiliate's evidence generation project plans.
- To manage the selection process of research sites and investigators, ensuring the engagement of investigators and institutions of high scientific relevance and in accordance with the corporate strategy.
- To support Medical Managers/Medical Director so that the evidence generation projects are aligned with the global and local strategies of the products and Therapeutic areas of interest, responding to scientific “gaps” validated with the “brands teams” of the affiliate.
- To ensure that all evidence generation procedures are in compliance with the regulations in force and SOPs in the area (local and global).
- To ensure budget planning and control of evidence generation projects, investigator-initiated studies as well as adequate payment from researchers, research sites and service providers.
- To support scientific partnerships with medical institutions and societies for scientific records, non-interventional studies, database analyses and other projects involving external collaboration.
- To ensure that “Evidence Generation” service providers are qualified, monitored/audited in accordance with AbbVie guidelines and local regulations.
Publications
- Serve as an Affiliate Publication Co-Lead.
- Ensure that the Affiliate’s Publication Plan is aligned with the Gap Assessment and Brand Plans.
- Support the development of scientific publications: results of local/regional studies, sub-analyses of global studies, pharmacoeconomic studies, database analysis, bibliographic reviews, and others.
- To ensure that local scientific publications are developed in accordance with AbbVie's policies.
- To ensure that external authors have authorship criteria to manage so that activities related to publication are carried out in accordance with AbbVie's policies.
Medical Operations
- Support MO&EG Manager in development and implementation Key Performance Metrics to measure the value and impact of Medical Affairs activities, ensure accurate and timely reporting to key business partners
- Support MO&EG Manager to plan and manage budget for the Medical Department
- To ensure the planning and maintenance of the Medical Team's quality process.
- To manage the development of strategies and planning for internal and external audits.
- To ensure the process of periodic development, control and updating of the Medical Team's organizational documents: organization charts, job descriptions, signature logs, CVs.
- To perform overall Risk Assessment of Medical related activities and advise MO&EG Manager on specific actions that need to be in place and not limited to interactions of Medical In-Field Team with HCPs, Promotional and Non-Promotional materials, Fair Market Value Tiering, etc.
- Collaborate with cross-functional business leaders regarding HEOR processes, solutions, and initiatives to achieve shared business objectives.
Others:
- Undergo and maintain training as required by Global Clinical Operations and other relevant company procedures, to ensure adherence to ICH GCP, AbbVie GPRD SOPs and IQS processes and procedures, local SOPs, applicable regulatory requirements, and study specific needs.
- Collect information from the market regarding market condition changes, registration regulations / guidelines, etc. changes and forward them to the direct supervisor regularly.
- Provide operational guidance where needed.
- Contribute to achieve satisfactory study audits.
- Ensure appropriate local SOP are in place to cover NIS conduct in the affiliate.
KEY INTERNAL AND EXTERNAL INTERFACES
Interacts with, builds and maintains professional and collaborative relationships with:
- Affiliate medical personnel: Head of Medical Affairs/Medical Director; Medical Operations and Evidence Generation Manager, Medical Managers/Advisers; Medical Science Liaison; Affiliate Safety Representative / drug safety personnel and Clinical Research Admin
- Clinical Site Management: Country Clinical Operations Head, Clinical Research Associate and Country Study Startup Specialist
- Other affiliate personnel: regulatory affairs, finance, legal etc.
- Area based Therapeutic Area medical affairs teams.
- Area Medical Affairs teams
- Participating research Investigators and study personnel; thought leaders/external experts.
- Hospitals, other healthcare providers, Ethics Committee and Local Regulatory Authorities.
- Third party vendor (e.g., CRO, data management)
Qualifications
- Appropriate medical background or healthcare-related qualification or experience.
- Typically, of 5 years’ Clinical Research experience, of which at least 3 years must be in clinical research monitoring, including demonstrable experience in clinical study coordination or management.
- Exhibits strong planning and organizational skills and the ability to work effectively and efficiently in a dynamic environment with competing projects and deadlines.
- Written and verbal fluency in English and Arabic.
- Acute observational skills, analytical and conceptual capabilities.
- Exhibits high degree of flexibility when facing changes in the work environment. Attention to details and strong interpersonal skills.
- Competence in the use of personal computers, including experience with word processing, spread sheets, email and web-browser applications.
- Ability to work independently with minimal supervision.
- Ability to travel regularly (approximately 25%)
- Experience in Medical Operations is preferred,
- Excellent knowledge of regulations governing clinical research, ICH/GCP Guidelines, and all applicable local regulations.
- Good knowledge of standard IT office tools: MS Office (Excel, Word, PowerPoint, Project, Access, Adobe Acrobat).
- Knowledge of statistical programs such as SAS, Statistica, R, PASS, Stata etc. is preferred.
- Managing obstacles using strong problem-solving skills
Additional Information
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.
US & Puerto Rico only - to learn more, visit
US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:
#J-18808-LjbffrMedical Operations & Evidence Generation Specialist
Posted today
Job Viewed
Job Description
Company Description
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at . on X , Facebook , Instagram , YouTube , LinkedIn and Tik Tok .
Job Description
DEPARTMENT FUNCTION AND OBJECTIVE
The local Medical Operations & Evidence Generation Team based in the Medical Department of the Saudi Affiliate (Medical Director, Medical Operations & Evidence Generation Manager, Medical Operations & Evidence Generation Specialist) has the overall responsibility for the development and execution of the Affiliate Medical Operations & Evidence Generation strategic plans.
PRIMARY FUNCTION
- To provide set-up, coordination, and execution of centrally or locally sponsored, international, and local Non-Interventional Studies (NIS) as a member of the Medical Department of AbbVie in the Affiliate.
- Reporting to the Medical Operations and Evidence Generation Manager, this position represents the country/region expertise for post-marketing observational and other non-interventional studies. The position provides operational advice/guidance to the Affiliate Medical Affairs organization for multi-country or local projects.
- Work with the Medical Director to ensure that the Medical Department delivers value to the affiliate, patients, and the medical community through excellence in the planning and execution of medical projects and activities in preparation for launches ("Launch Readiness"), leadership of the Gap Assessment and medical anchors of the Brand Plans, in-field medical team effectiveness, evidence generation, medical education, and all medical initiatives. Ensure the quality of processes and compliance in the Medical Team through the development and control of procedures and documentation, conducting audits of service providers, conducting internal audits, in accordance with local regulations and global requirements of AbbVie.
MAJOR DUTIES AND RESPONSIBILITIES
Clinical Research and Evidence Generation
- To lead the development and execution of different types of evidence generation: non-interventional studies, Pharmacoeconomics studies, epidemiological studies, Real World Evidence in collaboration with internal stakeholders including but not limited to Medical and Market access.
- To ensure the development of the affiliate's evidence generation project plans.
- To manage the selection process of research sites and investigators, ensuring the engagement of investigators and institutions of high scientific relevance and in accordance with the corporate strategy.
- To support Medical Managers/Medical Director so that the evidence generation projects are aligned with the global and local strategies of the products and Therapeutic areas of interest, responding to scientific "gaps" validated with the "brands teams" of the affiliate.
- To ensure that all evidence generation procedures are in compliance with the regulations in force and SOPs in the area (local and global).
- To ensure budget planning and control of evidence generation projects, investigator-initiated studies as well as adequate payment from researchers, research sites and service providers.
- To support scientific partnerships with medical institutions and societies for scientific records, non-interventional studies, database analyses and other projects involving external collaboration.
- To ensure that "Evidence Generation" service providers are qualified, monitored/audited in accordance with AbbVie guidelines and local regulations.
Publications
- Serve as an Affiliate Publication Co-Lead.
- Ensure that the Affiliate's Publication Plan is aligned with the Gap Assessment and Brand Plans.
- Support the development of scientific publications: results of local/regional studies, sub-analyses of global studies, pharmacoeconomic studies, database analysis, bibliographic reviews, and others.
- To ensure that local scientific publications are developed in accordance with AbbVie's policies.
- To ensure that external authors have authorship criteria to manage so that activities related to publication are carried out in accordance with AbbVie's policies.
Medical Operations
- Support MO&EG Manager in development and implementation Key Performance Metrics to measure the value and impact of Medical Affairs activities, ensure accurate and timely reporting to key business partners
- Support MO&EG Manager to plan and manage budget for the Medical Department
- To ensure the planning and maintenance of the Medical Team's quality process.
- To manage the development of strategies and planning for internal and external audits.
- To ensure the process of periodic development, control and updating of the Medical Team's organizational documents: organization charts, job descriptions, signature logs, CVs.
- To perform overall Risk Assessment of Medical related activities and advise MO&EG Manager on specific actions that need to be in place and not limited to interactions of Medical In-Field Team with HCPs, Promotional and Non-Promotional materials, Fair Market Value Tiering, etc.
- Collaborate with cross-functional business leaders regarding HEOR processes, solutions, and initiatives to achieve shared business objectives.
Others:
- Undergo and maintain training as required by Global Clinical Operations and other relevant company procedures, to ensure adherence to ICH GCP, AbbVie GPRD SOPs and IQS processes and procedures, local SOPs, applicable regulatory requirements, and study specific needs.
- Collect information from the market regarding market condition changes, registration regulations / guidelines, etc. changes and forward them to the direct supervisor regularly.
- Provide operational guidance where needed.
- Contribute to achieve satisfactory study audits.
- Ensure appropriate local SOP are in place to cover NIS conduct in the affiliate.
KEY INTERNAL AND EXTERNAL INTERFACES
Interacts with, builds and maintains professional and collaborative relationships with:
- Affiliate medical personnel: Head of Medical Affairs/Medical Director; Medical Operations and Evidence Generation Manager, Medical Managers/Advisers; Medical Science Liaison; Affiliate Safety Representative / drug safety personnel and Clinical Research Admin
- Clinical Site Management: Country Clinical Operations Head, Clinical Research Associate and Country Study Startup Specialist
- Other affiliate personnel: regulatory affairs, finance, legal etc.
- Area based Therapeutic Area medical affairs teams.
- Area Medical Affairs teams
- Participating research Investigators and study personnel; thought leaders/external experts.
- Hospitals, other healthcare providers, Ethics Committee and Local Regulatory Authorities.
- Third party vendor (e.g., CRO, data management)
Qualifications
- Appropriate medical background or healthcare-related qualification or experience.
- Typically, of 5 years' Clinical Research experience, of which at least 3 years must be in clinical research monitoring, including demonstrable experience in clinical study coordination or management.
- Exhibits strong planning and organizational skills and the ability to work effectively and efficiently in a dynamic environment with competing projects and deadlines.
- Written and verbal fluency in English and Arabic.
- Acute observational skills, analytical and conceptual capabilities.
- Exhibits high degree of flexibility when facing changes in the work environment. Attention to details and strong interpersonal skills.
- Competence in the use of personal computers, including experience with word processing, spread sheets, email and web-browser applications.
- Ability to work independently with minimal supervision.
- Ability to travel regularly (approximately 25%)
- Experience in Medical Operations is preferred,
- Excellent knowledge of regulations governing clinical research, ICH/GCP Guidelines, and all applicable local regulations.
- Good knowledge of standard IT office tools: MS Office (Excel, Word, PowerPoint, Project, Access, Adobe Acrobat).
- Knowledge of statistical programs such as SAS, Statistica, R, PASS, Stata etc. is preferred.
- Managing obstacles using strong problem-solving skills
Additional Information
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.
US & Puerto Rico only - to learn more, visit
US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:
Medical Operations & Evidence Generation Specialist
Posted 3 days ago
Job Viewed
Job Description
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas - immunology, oncology, neuroscience, and eye care - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at Follow @abbvie on X, Facebook, Instagram, YouTube, LinkedIn and Tik Tok ( .
Job Description
DEPARTMENT FUNCTION AND OBJECTIVE
The local Medical Operations & Evidence Generation Team based in the Medical Department of the Saudi Affiliate (Medical Director, Medical Operations & Evidence Generation Manager, Medical Operations & Evidence Generation Specialist) has the overall responsibility for the development and execution of the Affiliate Medical Operations & Evidence Generation strategic plans.
PRIMARY FUNCTION
+ To provide set-up, coordination, and execution of centrally or locally sponsored, international, and local Non-Interventional Studies (NIS) as a member of the Medical Department of AbbVie in the Affiliate.
+ Reporting to the Medical Operations and Evidence Generation Manager, this position represents the country/region expertise for post-marketing observational and other non-interventional studies. The position provides operational advice/guidance to the Affiliate Medical Affairs organization for multi-country or local projects.
+ Work with the Medical Director to ensure that the Medical Department delivers value to the affiliate, patients, and the medical community through excellence in the planning and execution of medical projects and activities in preparation for launches ("Launch Readiness"), leadership of the Gap Assessment and medical anchors of the Brand Plans, in-field medical team effectiveness, evidence generation, medical education, and all medical initiatives. Ensure the quality of processes and compliance in the Medical Team through the development and control of procedures and documentation, conducting audits of service providers, conducting internal audits, in accordance with local regulations and global requirements of AbbVie.
MAJOR DUTIES AND RESPONSIBILITIES
Clinical Research and Evidence Generation
+ To lead the development and execution of different types of evidence generation: non-interventional studies, Pharmacoeconomics studies, epidemiological studies, Real World Evidence in collaboration with internal stakeholders including but not limited to Medical and Market access.
+ To ensure the development of the affiliate's evidence generation project plans.
+ To manage the selection process of research sites and investigators, ensuring the engagement of investigators and institutions of high scientific relevance and in accordance with the corporate strategy.
+ To support Medical Managers/Medical Director so that the evidence generation projects are aligned with the global and local strategies of the products and Therapeutic areas of interest, responding to scientific "gaps" validated with the "brands teams" of the affiliate.
+ To ensure that all evidence generation procedures are in compliance with the regulations in force and SOPs in the area (local and global).
+ To ensure budget planning and control of evidence generation projects, investigator-initiated studies as well as adequate payment from researchers, research sites and service providers.
+ To support scientific partnerships with medical institutions and societies for scientific records, non-interventional studies, database analyses and other projects involving external collaboration.
+ To ensure that "Evidence Generation" service providers are qualified, monitored/audited in accordance with AbbVie guidelines and local regulations.
Publications
+ Serve as an Affiliate Publication Co-Lead.
+ Ensure that the Affiliate's Publication Plan is aligned with the Gap Assessment and Brand Plans.
+ Support the development of scientific publications: results of local/regional studies, sub-analyses of global studies, pharmacoeconomic studies, database analysis, bibliographic reviews, and others.
+ To ensure that local scientific publications are developed in accordance with AbbVie's policies.
+ To ensure that external authors have authorship criteria to manage so that activities related to publication are carried out in accordance with AbbVie's policies.
Medical Operations
+ Support MO&EG Manager in development and implementation Key Performance Metrics to measure the value and impact of Medical Affairs activities, ensure accurate and timely reporting to key business partners
+ Support MO&EG Manager to plan and manage budget for the Medical Department
+ To ensure the planning and maintenance of the Medical Team's quality process.
+ To manage the development of strategies and planning for internal and external audits.
+ To ensure the process of periodic development, control and updating of the Medical Team's organizational documents: organization charts, job descriptions, signature logs, CVs.
+ To perform overall Risk Assessment of Medical related activities and advise MO&EG Manager on specific actions that need to be in place and not limited to interactions of Medical In-Field Team with HCPs, Promotional and Non-Promotional materials, Fair Market Value Tiering, etc.
+ Collaborate with cross-functional business leaders regarding HEOR processes, solutions, and initiatives to achieve shared business objectives.
Others:
+ Undergo and maintain training as required by Global Clinical Operations and other relevant company procedures, to ensure adherence to ICH GCP, AbbVie GPRD SOPs and IQS processes and procedures, local SOPs, applicable regulatory requirements, and study specific needs.
+ Collect information from the market regarding market condition changes, registration regulations / guidelines, etc. changes and forward them to the direct supervisor regularly.
+ Provide operational guidance where needed.
+ Contribute to achieve satisfactory study audits.
+ Ensure appropriate local SOP are in place to cover NIS conduct in the affiliate.
KEY INTERNAL AND EXTERNAL INTERFACES
Interacts with, builds and maintains professional and collaborative relationships with:
+ Affiliate medical personnel: Head of Medical Affairs/Medical Director; Medical Operations and Evidence Generation Manager, Medical Managers/Advisers; Medical Science Liaison; Affiliate Safety Representative / drug safety personnel and Clinical Research Admin
+ Clinical Site Management: Country Clinical Operations Head, Clinical Research Associate and Country Study Startup Specialist
+ Other affiliate personnel: regulatory affairs, finance, legal etc.
+ Area based Therapeutic Area medical affairs teams.
+ Area Medical Affairs teams
+ Participating research Investigators and study personnel; thought leaders/external experts.
+ Hospitals, other healthcare providers, Ethics Committee and Local Regulatory Authorities.
+ Third party vendor (e.g., CRO, data management)
Qualifications
+ Appropriate medical background or healthcare-related qualification or experience.
+ Typically, of 5 years' Clinical Research experience, of which at least 3 years must be in clinical research monitoring, including demonstrable experience in clinical study coordination or management.
+ Exhibits strong planning and organizational skills and the ability to work effectively and efficiently in a dynamic environment with competing projects and deadlines.
+ Written and verbal fluency in English and Arabic.
+ Acute observational skills, analytical and conceptual capabilities.
+ Exhibits high degree of flexibility when facing changes in the work environment. Attention to details and strong interpersonal skills.
+ Competence in the use of personal computers, including experience with word processing, spread sheets, email and web-browser applications.
+ Ability to work independently with minimal supervision.
+ Ability to travel regularly (approximately 25%)
+ Experience in Medical Operations is preferred,
+ Excellent knowledge of regulations governing clinical research, ICH/GCP Guidelines, and all applicable local regulations.
+ Good knowledge of standard IT office tools: MS Office (Excel, Word, PowerPoint, Project, Access, Adobe Acrobat).
+ Knowledge of statistical programs such as SAS, Statistica, R, PASS, Stata etc. is preferred.
+ Managing obstacles using strong problem-solving skills
Additional Information
AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.
US & Puerto Rico only - to learn more, visit & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:
Manager - Medical Claims Operations (Pipeline)
Posted 8 days ago
Job Viewed
Job Description
To ensure that assigned provider’s Inpatient and Outpatient claims are medically & commercially adjudicated within the specified timeframe and within the targeted quality to achieve the business objective of delivering high-quality claim statements.
Adjudication- Process all daily batches of claims assigned in accordance with medical policy and Inpatient / Outpatient adjudication guidelines, utilizing medical expertise and instructed guidelines for smooth business operations.
- Ensure each claim is processed according to the checklist, including verification of physical claims or scanned images, cross-checking with electronic claims data on Edge, and reflecting the correct decision on the operations system.
- Achieve daily targets for the number of claims processed.
- Discuss high-profile or high-value claims with the claims medical manager when decisions are complex or require careful consideration.
- Maintain a minimum of 95% accuracy in monthly quality audits to meet quality standards.
- Make sound medical decisions that reduce the risk of challenges from providers, consulting with the medical manager when in doubt.
- Report abnormal provider practice trends related to adjudicated claims when necessary.
- Detect and escalate FWA (Fraud, Waste, and Abuse) cases to the relevant teams following claims handling guidelines.
Manager - Medical Claims Operations (Pipeline)
Posted 8 days ago
Job Viewed
Job Description
To ensure that assigned provider's Inpatient and Outpatient claims are medically & commercially adjudicated within the specified timeframe and within the targeted quality to achieve the business objective of delivering high-quality claim statements.
Adjudication- Process all daily batches of claims assigned in accordance with medical policy and Inpatient / Outpatient adjudication guidelines, utilizing medical expertise and instructed guidelines for smooth business operations.
- Ensure each claim is processed according to the checklist, including verification of physical claims or scanned images, cross-checking with electronic claims data on Edge, and reflecting the correct decision on the operations system.
- Achieve daily targets for the number of claims processed.
- Discuss high-profile or high-value claims with the claims medical manager when decisions are complex or require careful consideration.
- Maintain a minimum of 95% accuracy in monthly quality audits to meet quality standards.
- Make sound medical decisions that reduce the risk of challenges from providers, consulting with the medical manager when in doubt.
- Report abnormal provider practice trends related to adjudicated claims when necessary.
- Detect and escalate FWA (Fraud, Waste, and Abuse) cases to the relevant teams following claims handling guidelines.
Healthcare Operations Manager - Michael Page
Posted today
Job Viewed
Job Description
Top client specialize in the healthcare sector in the kingdom
**Job Description**:
- Supporting the Healthcare Sector Director to deliver the above in line with the Companies Vision, values and strategy, evidenced by accurate and timely reporting, clear communication.
- Overseeing a multi-site with multi-disciplined teams ( hospitals, clinics, Pharmacies)
- Build value and competitive advantage in the services across the business units of the sector
- Driving visible service delivery by ensuring a high level of care is achieved evident by internal and external inspection outcomes
- Periodically managing internal audits with regards to service standards and compliance ensuring that agreed KPIs are delivered
- Setting, Implementing targets and support the quality and financial performance of each site, evident through growth in each site's contribution and quality outcomes
- Supporting bespoke training and development plans for the Healthcare sector teams across all business units evidenced by monthly one to ones, quarterly supervisions and annual appraisals
- Implementing high morale and engagement and promoting a culture of outstanding performance & Excellent patient Experience journey
- Attracting, engaging, retaining and developing talent within each Hospital monitoring recruitment processes, turnover & attrition in line with company policies and procedures, ensuring that right to KSA & International accreditation standards are adhered to
- Developing and executing innovative approaches to maximize quality performance and regulatory outcomes
- Delivering end to end Staff management processes (where appropriate) in partnership with HR
- Maximizing profitability through revenue generation, expense control and ongoing market analysis
- Demonstrating an understanding of the unique niche within the market, planning forward to sustain the viability of the Hospitals to local market needs
- Ensuring regular and routine audit & leading to the development of action plans evidencing progress against prioritized actions
- Conduct comprehensive audit & site visit with each Hospital. Conduct unannounced hours visits to Hospital once a month or more frequently if the risk is perceived or inferred.
- Overall knowledge of Profit & Loss (P&L) business management (pricing, financial reporting, census measures, variance reports, labour reports, etc.)
- Understands and utilizes the business intelligence reports/tools to manage and enhance our business operation
- Attend and contribute to the corporate agenda, attending Quality Review Meetings and routine finance meetings and other meetings as required, sharing knowledge of the Hospitals
- Ensuring Hospitals & all business units are safe by ensuring Health & Safety policies and best practice are embedded and adhered to
The Successful Applicant
- 15 years of experience (At least 5 years in similar position in KSA )
- Experienced in healthcare operations management, preferably within a hospital and polyclinic setting.
- Proficient in strategic planning and resource optimization to ensure efficient operations.
- Skilled in budget management and financial analysis to maximize profitability.
- Strong leadership abilities to oversee and motivate a diverse team of healthcare professionals.
- Experience in JCIA organizations is preferred
What's on Offer
competitive salary, be part of a transformational business
This job has been sourced from an external job board.
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Clinical Research Coordinator
Posted today
Job Viewed
Job Description
**Essential Responsibilities and Duties**:
1. Participates in the design and execution of clinical research projects and ensures compliance with protocols and objectives. Assists in preparing amendments to protocols and/or modifications to stud design as appropriate.
2. Facilitates and coordinates the daily clinical research activities and plays a critical role in the conduct of the study. Assists in the determination of guidelines for the collection of clinical data and/or administration of clinical studies.
3. Performs data collection, entry, and statistical analysis. Evaluates and interpret collected clinical data in conjunction with the principal investigator(s) as appropriate.
5. Participates in recruiting patients, obtaining informed consent, collecting clinical samples, recording vital signs, filling up questionnaires, ensuring that all necessary forms and documentation are complete, develop in forms and other documentation required for the project.
6. Performs regular project communications, recordkeeping, and administrative duties as assigned. 7. Provides support to the Clinical Research team, including preparation of technical reports as needed, and ensures timely completion of tasks.
**Education**:
Master’s or Bachelor’s Degree in a Health Science related discipline, Nursing, Pharmacy or other related discipline is required.
**Experience Required**:
Two (2) years of related experience with Master's, or four (4) years with Bachelor's Degree is required.
**Other Requirements(Certificates)**:
- Saudi National Only.
- A successful completion of either a Clinical Research Professional course (offered in house) or any other accredited online course is preferred.
- A certificate of completion of the NIH (National Institutes of Health) web-based training course: "Protecting Human Research Participants" is preferred.
Experienced Clinical Research Associate Sponsor-dedicated
Posted 2 days ago
Job Viewed
Job Description
Job Overview
Perform monitoring and site management work to ensure that sites are conducting the study(ies) and reporting study data as required by the study protocol, applicable regulations and guidelines, and sponsor requirements.
Essential Functions
• Perform site monitoring visits (selection, initiation, monitoring and close-out visits) in accordance with contracted scope of work and Good Clinical Practice.
• Work with sites to adapt, drive, and track subject recruitment plan in line with project needs to enhance predictability.
• Administer protocol and related study training to assigned sites and establish regular lines of communication with sites to manage ongoing project expectations and issues.
• Evaluate the quality and integrity of study site practices related to the proper conduct of the protocol and adherence to applicable regulations. Escalate quality issues as appropriate.
• Manage the progress of assigned studies by tracking regulatory submissions and approvals, recruitment and enrollment, case report form (CRF) completion and submission, and data query generation and resolution. May support start-up phase.
• Ensure copies/originals (as required) site documents are available for filing in the Trial Master File (TMF) and verify that the Investigator's Site File (ISF) is maintained in accordance with GCP and local regulatory requirements.
• Create and maintain appropriate documentation regarding site management, monitoring visit findings and action plans by submitting regular visit reports, generating follow-up letters and other required study documentation.
• Collaborate and liaise with study team members for project execution support as appropriate.
• If applicable, may be accountable for supporting development of project subject recruitment plan on a per site basis.
• If applicable, may be accountable for site financial management according to executed clinical trial agreement and retrieve invoices according to local requirement.
Qualifications
• High School Diploma or equivalent Degree in scientific discipline or health care preferred.
• Requires at least 2 years of year of on-site monitoring experience.
• Equivalent combination of education, training and experience may be accepted in lieu of degree.
• Good knowledge of, and skill in applying, applicable clinical research regulatory requirements.
• i.e., Good Clinical Practice (GCP) and International Conference on Harmonization (ICH) guidelines.
• Good therapeutic and protocol knowledge as provided in company training.
• Computer skills including proficiency in use of Microsoft Word, Excel and PowerPoint and use of a laptop computer and iPhone and iPad (where applicable).
• Written and verbal communication skills including good command of Arabic and English language.
• Organizational and problem-solving skills.
• Effective time and financial management skills.
• Ability to establish and maintain effective working relationships with coworkers, managers, and clients.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled
#J-18808-LjbffrExperienced Clinical Research Associate Sponsor-dedicated
Posted 12 days ago
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Job Description
Perform monitoring and site management work to ensure that sites are conducting the study(ies) and reporting study data as required by the study protocol, applicable regulations and guidelines, and sponsor requirements.
Essential Functions
- Perform site monitoring visits (selection, initiation, monitoring and close-out visits) in accordance with contracted scope of work and Good Clinical Practice.
- Work with sites to adapt, drive, and track subject recruitment plan in line with project needs to enhance predictability.
- Administer protocol and related study training to assigned sites and establish regular lines of communication with sites to manage ongoing project expectations and issues.
- Evaluate the quality and integrity of study site practices related to the proper conduct of the protocol and adherence to applicable regulations. Escalate quality issues as appropriate.
- Manage the progress of assigned studies by tracking regulatory submissions and approvals, recruitment and enrollment, case report form (CRF) completion and submission, and data query generation and resolution. May support start-up phase.
- Ensure copies / originals (as required) site documents are available for filing in the Trial Master File (TMF) and verify that the Investigator's Site File (ISF) is maintained in accordance with GCP and local regulatory requirements.
- Create and maintain appropriate documentation regarding site management, monitoring visit findings and action plans by submitting regular visit reports, generating follow-up letters and other required study documentation.
- Collaborate and liaise with study team members for project execution support as appropriate.
- If applicable, may be accountable for supporting development of project subject recruitment plan on a per site basis.
- If applicable, may be accountable for site financial management according to executed clinical trial agreement and retrieve invoices according to local requirement.
Qualifications
- High School Diploma or equivalent Degree in scientific discipline or health care preferred.
- Requires at least 2 years of year of on-site monitoring experience.
- Equivalent combination of education, training and experience may be accepted in lieu of degree.
- Good knowledge of, and skill in applying, applicable clinical research regulatory requirements.
- i.e., Good Clinical Practice (GCP) and International Conference on Harmonization (ICH) guidelines.
- Good therapeutic and protocol knowledge as provided in company training.
- Computer skills including proficiency in use of Microsoft Word, Excel and PowerPoint and use of a laptop computer and iPhone and iPad (where applicable).
- Written and verbal communication skills including good command of Arabic and English language.
- Organizational and problem-solving skills.
- Effective time and financial management skills.
- Ability to establish and maintain effective working relationships with coworkers, managers, and clients.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at
Experienced Clinical • Riyadh, Saudi Arabia
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