Lead - Policy Management (Insurance TPA)
Skills
About This Role
Job Description
1.
Job Purpose
The jobholder is responsible to serve as the primary point of expertise for regulatory requirements, process optimization, and best practices within the region.
The jobholder will provide guidance and in-depth knowledge to both your team and cross-functional partners, ensuring accuracy and consistency in compliance matters.
Your role
will include developing training materials, advising on complex cases, and supporting audits and reviews to uphold the highest standards of operational excellence.
2.
And Duties
· Develop process for the Middle East Compliance and Eligibility Analysts, leveraging existing tools and developing new tools to optimize productivity, service quality, and meet all performance metrics and timelines.
· Create and define processes for consistency and effectiveness for Americas and Europe processes for Dubai based analysts to support global needs.
· Collaborate with teams and managers to resolve escalated issues promptly, using data analysis to identify root causes and prevent recurrence locally and globally.
· Act as a departmental liaison, driving compliance and quality-focused continuous improvement initiatives that support business and eligibility team needs.
· Collaborate with matrix partners to ensure timely and accurate resolution of escalations.
· You’ll work alongside the team to play a critical role in ensuring accurate and timeliness of client set up, enrollment processing which directly impacts customer access to care and benefit coverage and Middle East compliance requirement.
· For eligibility, responsible for managing client eligibility data, intake and processing, resolving data integrity issues, developing tools to ensure accurate and efficient eligibility loading, and coordinating with third-party vendors for seamless service delivery.
Improve processes for compliance requirements ensure being followed and focus on preventing financial risks and access to care timely.
· Other duties as assigned.
3. Knowledge, Skills And Experience
· High school diploma or GED required; bachelor’s degree preferred.
· 3+ years of experience in leadership, management, or coaching, preferred.
· Skilled in building strong relationships and driving change through collaboration across all levels, preferred.
· Client-focused with strong interpersonal and influencing skills, proven ability to assess talent and personalities, and build effective relationships, preferred.
· Experienced in managing complex operational work units within a matrixed environment.
· Ability to manage multiple priorities while thriving in a collaborative, high-energy team environment.
· Effective communicator with strong written, oral, interpersonal, analytical, and listening skills.
Pay: AED7,000.00 - AED7,500.00 per month
Experience
- Medical Insurance: 2 years (Required)
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