Open To Work
Dr. Emad Malak
Hawally,Kuwait
Summary
An experienced physician graduated from Cairo University ( Kasr AL Aini) 1996 worked in many hospitals and Health services industry , insurance & TPA companies with almost 25 years of experience in insurance, business development management,and high management experience across all related cultures.
Overview
29
29
years of professional experience
9
9
years of post-secondary education
Work History
Insurance Manager
HADI HOSPITAL
06.2020 - Current
- Achieved the less rejections rate all over Kuwait. (Reduced rejections rate with GIG. From very high rate to the fewer rates in Kuwait).
- Educating doctors, nurses, other departments about insurance guidelines either medical or nonmedical.
- Management of internal operations of the department.
- Provide training programs, educational sessions belonged to insurance medical cases studies direct with all physicians & HOD, medical director, top management.
- Minimize loss ratio either technical or medical.
- Claims reconciliation and final payments.
- Strategy planning of the department which reflects hospital plan and view.
- Implantation of new solutions and process.
- Business development management and growth either insurance or cash patients.
- Introduce solutions to work flow and planning strategies of hospital with management of operations inside all departments.
Medical & life Claim and underwriting Manager
T'azur Takaful Insurance Company-KW
07.2013 - 06.2019
- Supervise all the pre-approval requests from all providers to take a decision either approved or rejected.
- Medical & life claim audit and follow up.
- Contacting NAS, GLOBEMED, WEBMED and other TPA companies for further processing of pre-approval requests and medical claims from all providers inside KUWAIT.
- Provide training to all TPA companies and T'azur medical claim team.
- Provide medical advices for TPA.
- Work as medical advisor and secondary opinion for all TPA (NAS, GOLBEMED and WEBMED).
- Resolving problems and complaints from both hospitals and clients to facilitate the services.
- Explain policy to both providers and clients.
- Leads the development, approval, authorization of agreed clinical policies.
- Kuwait
Associate Medical Director
International Hospital Bahrain
12.2011 - 01.2013
- Provide help and support to all doctors and medical staff.
- Manage the duties of doctors and sharing the decisions of their appraisal and evaluation of their performance.
- Planning of the future plans to achieve the hospital targets and goals.
- Recruitment of medical staff.
- Supervising the Insurance department and obtaining approval requests.
- Follow up resubmission of claims and negotiate rejections with insurance companies.
Insurance Manager and associate CEO
Bahrain Specialist Hospital
03.2009 - 12.2011
- General Management of Insurance Claims.
- Medical Audit of Inpatient cases.
- Contact Insurance Companies.
- Inpatient Cases pre-approval and outpatients services.
- Provide training & follow up of the Insurance Team members (72 Employers).
- Quality assurance management.
- Planning and follow up of hospital operations.
Assistant CEO and Vise General Manager
Gulf Union Insurance Bahrain
04.2007 - 03.2009
- Leads the organisation clinical staff and serves as a role model for professional excellence.
- Advise the corporate team to help shape and agree the strategic and operational plans for the organisation.
- Advises on the organisation and structure of medical services.
- Review department and division reports and makes recommendations for improving services.
- Leads the development, approval, authorisation of agreed clinical policies and procedures.
- Leads the development, review and implementation of the hospitals performance management system, including the peer review and productivity and review processes.
- Participates with the corporate team in budget planning and other financial management responsibilities as required.
- Assumes responsibility for establishing a clear system of communication with all medical workforce throughout the organisation.
- Attends all relevant corporate meetings with staff and department heads.
- Leads medical workforce planning for the organisation.
- Leads the appointments of Department Chairs and division Chiefs and assist in the appointment of other members of the corporate teams as required.
- Fostering relationships with fellow medical leaders, academics and clinicians, and supports Department Heads and division chiefs in handling the collaboration of research and exchange of best practice ideas.
- Helping to build the organisations reputation of clinical excellence.
- Support initiative for collecting information on patient satisfaction across the hospital and uses the information to assist in the strategic and operational planning.
- Delegates responsibility to the Deputy Medical Officers and other members of staff as required.
- Management of the teams to achieve targets and follow up the productivity and quality of the teams.
- Planning for medical audit plans parallel with the most recent medical guidelines.
- Controlling frauds.
- Visiting all providers personally to resolve problems and negotiation of medical procedures with the concerned consultants depending on my medical experience in the field.
- Building of relationships with the key persons in hospitals to facilitate the way of direct connection.
Private hospital owner
AL ZHOOR HOSPITAL
02.2004 - 11.2008
- 12 bed) General Manager AL ZHOOR HOSPITAL.
- MANAGEMENT of outpatient cases in Orthopedic clinic.
- Performing all kinds of operations for spinal cord and knee surgeries through complete medical team.
- Administration of the whole hospital.
- Monitoring of ICU and critical cases.
- Managing all the emergencies and follow up all cases plus monitoring all kinds of operations done in the hospital.
- Practice all cases of different specialties.
Emergency Doctor
01.1997 - 02.2008
Senior Medical Officer
ALICO Egypt
01.2006 - 02.2007
- Pre-approval replies.
- Roving Doctor & Network Manager to build up professional relationship between the company & providers.
- Medical Claims Audit & Negotiation.
- Reconciliation with providers for all major claims.
- Revision of medical files and negotiation with consultants and treating doctors for the medical justification of the services provided.
Medical officer
EDC Trimedica Insurance
01.2005 - 01.2007
- Replies of medical queries.
- Replies of pre-authorization requests from hospitals.
- Resolving problems and direct contact with both client and treating doctors.
Medical Officer
Egy-Med
03.2001 - 04.2004
Medical Representative
01.1998 - 02.1999
Emergency Doctor
Kasr Al Aini Hospital
03.1997 - 03.1998
Education
Quality and assurance - Quality And Assurance
01.2011 - 01.2012
First Part (Master Degree) - Orthopedic And Spinal Surgery
01.2000 - 05/2001
Bachelor of Medicine And Surgery
01.1990 - 09.1997
Skills
- Bussiness development Managment
- Health care industry awareness and development
- Problem-solving abilities
- Strategic planning
- Adaptability and flexibility
- Team building
- Excellent communicatio
- Problem-solving aptitude
- Attention to detail
- Multitasking
- Work planning
- Strategic communication management professional (SCMP)
- Task prioritization
Personal Information
Willing To Relocate if any.
Languages
Arabic
First Language
English
Proficient
C2
Work Preference
Work Type
Full TimeLocation Preference
On-SiteTimeline
Insurance Manager - HADI HOSPITAL
06.2020 - Current
Medical & life Claim and underwriting Manager - T'azur Takaful Insurance Company-KW
07.2013 - 06.2019
Associate Medical Director - International Hospital Bahrain
12.2011 - 01.2013
ISO9011 - Quality and assurance, Quality And Assurance
01.2011 - 01.2012
Insurance Manager and associate CEO - Bahrain Specialist Hospital
03.2009 - 12.2011
Assistant CEO and Vise General Manager - Gulf Union Insurance Bahrain
04.2007 - 03.2009
Senior Medical Officer - ALICO Egypt
01.2006 - 02.2007
Medical officer - EDC Trimedica Insurance
01.2005 - 01.2007
Private hospital owner - AL ZHOOR HOSPITAL
02.2004 - 11.2008
Medical Officer - Egy-Med
03.2001 - 04.2004
Cairo university - First Part (Master Degree), Orthopedic And Spinal Surgery
01.2000 - 05/2001
Medical Representative -
01.1998 - 02.1999
Emergency Doctor - Kasr Al Aini Hospital
03.1997 - 03.1998
Emergency Doctor -
01.1997 - 02.2008
Cairo University - , Bachelor of Medicine And Surgery
01.1990 - 09.1997