Mohammed Amin Abdul Malek

o Regional Frontline Leader reporting to Assistant Manager Primary Care Services, Regional Lead for Continual Continuous Improvement and Primary Health Leadership Team. Administrator to Support clinic operations. Strategic Planning, Budgeting and Cost Control, Optimization of resources to reduce over-time and Revenue Cycle.

o Regional Lead for Quality and Governance achieved highest level Diamond Accreditation by Accreditation Canada since the last 3 cycles.

o Lead a team for implementation CFCC/People Centred Care which resulted in customer satisfaction rating from 90 -96% during the period 2022-2024.

o Handling Customer Feedback Complaints and resolving conflicts. Persistently achieved a customer satisfaction rating for the Health Center above 90%

· Carrying out the occupational health pre-employment health check, assessing fitness to work, periodic medical and Case Management.

· Billing and Cost Packages for QatarEnergy Medical Services. Reduce claim rejections of the team by education, training and awareness of Medical Insurance Claims processes and Coding.

· Optimization of resources to achieve a reduction in overtime by 42% in the last 4 years.

• Operations and Management of QatarEnergy Dukhan Healthcare Centre including Strategic Planning, Delivery of Regional Remote Healthcare Services, Capex, Operating Budgets and Contracts.
• Physician with clinical management of applications for Primary Care, Urgent Care and Occupational Medicine including Pre employment Health evaluation, Fitness to work, Hazard Identification and Risk Assessment and Case Management.
• Medical audit and Quality Management Auditor for the Health Services Company including TPA representative in Audits by Insurance companies and Ombudsman.
• Medical Claims and Pre-authorization Management with Healthcare Providers Relations
• Human resources recruitment to build a team of Health Professionals.
• Deft in conducting inspections including QMS audits and enforcing adherence to laws and regulations governing the health and safety of individuals.
• Well versed with accreditation of Healthcare Services including JCI and AC procedures
• Strong communication skills, analytical ability and capability to perform under stress & strenuous conditions.
• Lead Primary Care Physician Jan 2021 till date

• Paramount Health Care Services was one of the leading TPA which had a client base of 2.5 million lives with 27 branch offices across India.
• Negotiating with various Health Care Providers for settlement of claims.
• Designing Cost Packages for health care providers using integrated care pathways (ICP) to reduce average length of stay in hospitals.
• Replying to the legal notices from a medical perspective in the cases of disputes.
• Attending Ombudsman and Consumer Court as a professional representative of the medical insurance company in cases of disputes.
• Handling recruitment of Medical Professionals and building a team of Medical Professionals for all departments
• TPA representative during external audit by various medical insurance companies and corporate clients
• Conducted Medical audit of various other branch offices of the company.
• Served as a part of the team with the Claims and Finance Department which reduced the cycle time for payment of claims from 7 working days to 5 working days
• Rendered services as Team Leader of the Medical Scrutiny department with a team of 15 Physicians
• Key Result Areas

• Team Leader for the claims and pre-authorization department of Millah Health Care Services
• Handled In-house clinics for various companies independently
• Responsible for recruitment of Medical Professionals and building a team of Medical Professionals
• Highlight: Instrumentally achieved a TAT for pre-authorization request response time of 10 minutes with active support from the IT Department.
• Provider Relations with various Healthcare Providers for Claims settlement and Cost Packages.
• Customer Relations with various corporate clients.