Health Insurance (SME) – Healthcare | Qatar
About The Role
Health Insurance SME – Healthcare
Tax Free Salary – Commensurate with experience
Health Insurance SME – to assist Insurance project manager with best value operational and Insurance solutions
– Qualified candidates will have operational & technical management level experience with responsibility for all aspects of health insurance operations
– SME should guide in development of technical solutions , evaluating organizational needs and recommending required solutions. You may also be required to oversee the development, testing, and implementation of various technical and operational processes.
- Expertise in all areas of health insurance operations technical activities
- To work with Project manager in developing, implementing, and maintaining operational requirements, including standard operating procedures, as well as databases, to manage and analyze programmatic information such as routine and ad hoc reports, deliverables, and programmatic documentation
- Supporting insurance project manager & working groups to provider assistance in significant changes
- Working with teams and external audiences as needed to facilitate the implementation of successful transition strategies in coordination with Project manager
- Assist & support project manager to effective delivery and technical direction for the implementation of primary care Electronic Medical Records (EMR) and Cerner Health Information Management solutions.
- Assist insurance project manager in developing & implementing medical coding standards for Insurance
- Assist in developing and implementing revenue cycle management (RCM) solutions for insurance
- Assessing the effectiveness and efficiency of executing health insurance operations and making recommendations to be reviewed by project managers & stakeholders
- With Project manager, support relevant activities associated with changes, transition management, and new initiatives
- To assist subject expertise and guidance to IT developers during the software development life cycle.
- Verifying technical reference information, including user guides, training manuals, and system requirements.
- Proactively manages and coordinates activities to ensure timeliness of deliverables to exceed contractual obligations in coordination with insurance project manager
- Monitor processes as directed by insurance project manager to identify program vulnerabilities and ensure compliance with Health Insurance Payers agreements/contracts and all statutory, regulatory, and sub-regulatory requirements are met.
- Ability to clearly communicate and exchange information with co-workers, teammates, stakeholders, and other personnel, as required
- Experience in implementing data sets as per client’s requirements ensuring zero rejections
Skills and Experience
- 7+ years of experience working in the relevant area of expertise
- 3 – 4 years of experience in DRG (diagnosis-related group) based health insurance in implementation of health insurance projects
- Sound knowledge and experience in medical coding is added advantage
- Cerner (Clinical Information system), myCARE & RCM experience is preferred
- Expertise in all areas of health insurance operations
- Competency in electronic business management systems
- Advanced ability to recommend and implement technical solutions for cross-functional
- Excellent communication and presentation skills and the ability to deliver executive level presentations are required.
- Business Administration graduate
- Masters degree is preferred
- Certification in Project Management or Health Care Management
Doha – Qatar