Medical insurance manager

Job Summary

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.