Medical Team Leader – Approvals & Operations

About the role

MedNet Egypt is seeking a skilled Medical Team Leader to manage the approvals team for inpatient and outpatient services. You will ensure that all medical requests are processed accurately, meet quality standards, and comply with service level agreements.

Key responsibilities

• Oversee inpatient and outpatient medical operations, ensuring team productivity meets targets and SLAs.
• Conduct daily audits of medical approvals to verify compliance with policies and procedures.
• Identify and investigate potential fraud or abuse cases from providers or clients.
• Provide medical and technical guidance to staff and support international accounts.
• Plan and schedule manpower to optimize operational efficiency.
• Participate in regional transformation projects and assist other MedNet operations as needed.
• Lead, coach, and develop staff to maintain high processing quality.
• Review treatment plans against medical guidelines, arrange second opinions, and monitor admitted cases.
• Negotiate hospital costs, secure better treatment options, and maintain referral matrices.
• Handle provider, client, and insurer inquiries to ensure timely resolution.
• Prepare regular performance and medical trend reports highlighting savings and outcomes.
• Maintain accurate medical records and ensure proper documentation filing.

Required profile

• Bachelor’s degree in Medicine.
• At least four years of experience in a related medical field.
• Experience in medical approval, call‑center, or claims activities within insurance, TPA, or MSO environments is a plus.
• Strong command of English, both written and verbal.
• Excellent leadership, planning, and organizational abilities.
• Analytical, problem‑solving, and decision‑making skills.

Required skills

• Proficiency with MS Office (Excel, PowerPoint, Word).