Roving Doctor
Walaa Cooperative Insurance Co. · Riyad
وصف الوظيفة
About the role
The Roving Doctor provides medical expertise across multiple hospital sites, ensuring high‑quality inpatient care while complying with clinical standards. This position requires frequent travel, flexibility, and the ability to support diverse healthcare teams.
Key responsibilities
- Manage a network of hospitals to guarantee optimal patient outcomes within agreed quality parameters.
- Collaborate with consultants and medical directors to develop and monitor case‑management plans.
- Escalate critical issues to the provider’s medical management team as needed.
- Coordinate with insurance offices and provider management to align approvals, invoicing, and claim decisions.
- Maintain communication with inpatients and families to enhance the company’s image and resolve issues.
- Provide daily updates on inpatient cases, including justification for clinical decisions.
- Submit savings, fraud, and high‑value claim reports to the Medical Approvals Manager.
- Gather and report market and competitor insights to the regional team.
- Ensure compliance with local healthcare regulations, patient safety, and confidentiality standards.
- Conduct medical audits, identify documentation gaps, and recommend corrective actions.
Required profile
- Bachelor’s degree in medicine; preferably a diploma or master’s in a clinical specialty.
- At least 2 years of experience in a roving medical role or active clinical practice.
- Familiarity with health‑insurance policies, regulations, and claims adjudication.
- Strong diagnostic and clinical decision‑making abilities.
- Excellent communication, interpersonal, and negotiation skills.
- Willingness to travel frequently and work flexible hours.
Required skills
- Proficiency with Electronic Medical Record (EMR) systems.
- Experience using reporting tools for medical and compliance data.
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Walaa Cooperative Insurance Co.
Riyad
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