Medical insurance manager
Medical Insurance Manager Location: Jeddah, Saudi Arabia Employment Type: Full-Time Job Summary Amer Care Home Healthcare is seeking an experienced Medical Insurance Manager to establish and lead the Medical Insurance Department.
Skills
About This Role
Job Summary
Amer Care Home Healthcare is seeking an experienced Medical Insurance Manager to establish and lead the Medical Insurance Department.
The successful candidate will be responsible for developing insurance operations, securing contracts with insurance companies and TPAs, managing payer relationships, overseeing approvals and claims processes, and driving revenue growth through strategic partnerships.
Key Responsibilities
- Establish and manage the Medical Insurance Department from the ground up.
- Develop policies, procedures, and workflows for insurance operations.
- Identify, negotiate, and secure contracts with insurance companies and Third-Party Administrators (TPAs).
- Build and maintain strong relationships with insurance providers and key stakeholders.
- Lead the credentialing and onboarding process with insurance networks.
- Oversee insurance approvals, claims submission, and reimbursement processes.
- Monitor claim performance, denials, and collection metrics to optimize revenue.
- Ensure compliance with CCHI requirements and relevant healthcare regulations.
- Collaborate with clinical, finance, and operations teams to improve insurance processes.
- Analyze market opportunities and expand the company’s insurance network.
- Prepare management reports, forecasts, and strategic recommendations.
Requirements
- Bachelor’s degree in Healthcare Administration, Business Administration, Finance, or a related field.
- Minimum 5 years of experience in medical insurance, provider relations, or healthcare contracting.
- Proven experience in securing and managing contracts with insurance companies and TPAs.
- Strong understanding of healthcare reimbursement, approvals, claims, and revenue cycle management.
- Excellent negotiation and relationship management skills.
- Experience in establishing or developing insurance departments is highly preferred.
- Knowledge of Saudi healthcare insurance regulations and CCHI requirements.
Benefits
- Competitive salary and performance-based incentives.
- Leadership role with significant growth opportunities.
- Opportunity to build and lead a key department within a growing healthcare organization.
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