Care Advisor

Overview

The Care Advisor position is a versatile role demanding comprehensive management of cases across several service areas including Customer Care, Home Nursing, Voice of Customer (VOC), Second Medical Opinion (SMO), complaint handling, and email communications.

This role calls for adaptability, robust clinical and operational knowledge, along with strong communication abilities to effectively manage a range of cases ensuring prompt resolutions, superior service quality, and customer satisfaction.

Key Responsibilities

• Manage and respond to emails from members, providers, payers, and clients promptly, ensuring patient needs are met without delay.
• Oversee complete processing of Complaints, Home Nursing, and Second Medical Opinion cases including reviewing documents, coordinating with medical experts, and delivering outcomes on time.
• Collect and address customer feedback and escalations across various channels with professionalism and timely resolution.
• Take full responsibility for complex and sensitive escalated cases by investigating thoroughly and ensuring effective resolution and follow-up.
• Maintain clear and professional communication with members, providers, and other stakeholders to provide accurate information on all platforms.
• Comply with medical guidelines, corporate policies, turnaround times, data protection, and quality standards for all cases.
• Keep precise records of cases and generate structured reports, dashboards, and insights to aid decision-making and audit processes.
• Analyze customer data and operational trends to determine root causes and recommend improvements in service and processes.
• Coordinate seamlessly with internal departments (claims, medical, providers, network) to ensure service delivery consistency and alignment.
• Handle a large caseload efficiently by prioritizing tasks, meeting deadlines, and maintaining performance under pressure.
• Display empathy and professionalism, enhancing the customer experience and working proactively to minimize repeated complaints.
• Show accountability, integrity, and flexibility; assist audits, contribute to quality initiatives, and mentor junior colleagues.

Qualifications and Requirements

• A Bachelor's degree is required; preference given to candidates with a medical background.
• Minimum of two years’ experience in a call center or customer service setting; experience with Third Party Administrators (TPA), hospitals, or medical centers considered beneficial.
• Excellent communication skills in English; additional languages are advantageous.
• Strong grasp of customer service fundamentals and telephone etiquette.
• Physically capable of fulfilling job responsibilities.
• Legally authorized to work in Qatar.
• Proficiency in Microsoft Office suite (Excel, Word, Outlook, PowerPoint) and competent in internet research and navigation.