Medical Manager

Jobfinders

Responsibilities:

• Ensure the proper implementation of the established policies and procedures in the department
• Participate in the development and continuous improvements of the Medical Department policies and procedures and recommend any changes.
• Participates in the development of the medical insurance strategy aiming at achieving the targeted business plan.
• Prepare annual budget for the Medical Department in accordance with preset budget preparation procedures and submit to the CM.
• Ensure proper underwriting to each quotation submitted.
• Overview requests regarding changes in policies' terms and conditions.
• Review and compare periodic reports and suggests action plans to keep up with the required growth and profitability.
• Approve the summary of the Department premiums and claims at year-end and report same to the CM.
• Review and approve the claims bordereaux sent by the TPA
• Handle the TPA Service Agreement for each Area and ensure applying its terms and conditions
• Present the Reinsurance Statements of Accounts to the CM for authorization and approval of remittance to the Reinsurer by the related Areas.
• Coordinate with the Reinsurance Department on matters relating to the Reinsurance Treaties Terms, Structures and negotiations.
• Coordinate with the Reinsurer and the TPA on every aspect of the medical operation
• Ensure proper training and full support to all medical staff under his/her responsibility.
• Meet with the Department Supervisor to discuss business operations and staff performance.
• Review with CM the business plan and discuss the means for achieving the targets.
• Perform other related duties as assigned or requested by CM

Qualifications:

• Bachelor s degree
• Pursuing a formal underwriting training (ACII, etc.) is desired
• Has a minimum of ten to fifteen years experience in insurance, seven of which in the same line.
• Must be fluent in both English & Arabic