Specialist- Insurance Claims(UAE National Only)

1. Regulatory Framework Development and Compliance

  • Spearhead the establishment, implementation, and periodic review of comprehensive healthcare regulatory frameworks in alignment with legal and industry standards.
  • Oversee the licensing, compliance monitoring, and performance evaluation of stakeholders across the healthcare ecosystem.
  • Ensure consistent enforcement of regulations and promote a transparent, accountable healthcare environment.
  • Contribute to the formulation of policies and regulatory instruments that enhance healthcare system integrity and sustainability.

2. Stakeholder Management and Market Oversight

  • Monitor payer and provider market participants to ensure adherence to established regulatory and operational requirements.
  • Address stakeholder concerns, inquiries, and compliance issues in a timely and professional manner.
  • Facilitate effective engagement with public and private healthcare entities to ensure smooth and compliant health insurance operations.
  • Maintain strong relationships with internal and external stakeholders to promote coordination and policy alignment.

3. Organizational Oversight

  • Lead and manage a multidisciplinary team responsible for regulatory, operational, and analytical functions within the Corporation.
  • Ensure the efficient execution of departmental objectives and the integration of cross-functional initiatives.
  • Participate in high-level leadership meetings and strategic planning forums with both public and private sector partners.
  • Promote a culture of performance excellence, professional development, and continuous improvement.


4. Technology Governance and System Implementation

  • Oversee the operation, maintenance, and enhancement of the eClaimLink system, ensuring data integrity, vendor compliance, and system reliability.
  • Lead the implementation and operationalization of the Diagnosis Related Group (DRG) healthcare payment system to streamline claims and improve cost efficiency.
  • Supervise technology vendors and ensure system developments align with regulatory and operational requirements.
  • Support digital transformation efforts aimed at enhancing transparency, efficiency, and data-driven decision-making.

5. Data Science, Analytics, and Insight Generation

  • Direct data science activities, including the extraction, analysis, and interpretation of large healthcare datasets to support strategic initiatives.
  • Provide analytical insights and evidence-based recommendations to guide leadership decisions and regulatory interventions.
  • Develop and maintain analytical tools and dashboards to monitor healthcare market trends and system performance.
  • Ensure the responsible and ethical use of data in alignment with corporate governance and privacy standards.

6. Strategic Advisory and Executive Support

  • Serve as a consultant and subject matter expert to the CEO, offering insights on health regulation, operations, and market dynamics.
  • Contribute to strategic projects, policy formulation, and inter-agency initiatives to advance Dubai’s healthcare vision.
  • Represent the organization in external meetings, committees, and forums to advocate for regulatory and operational best practices.
  • Support executive decision-making through comprehensive reports, strategic briefs, and technical recommendations.

Qualifications


Minimum Qualification: Masters in related field

Minimum Work Experience: Min 8 years

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