Head of Department ( Medical and Life Insurance Claims )

Head of Department ( Medical and Life Insurance Claims )Head of Department ( Medical and Life Insurance Claims )Get AI-powered advice on this job and more exclusive features.Direct message the job poster from Global Recruitz Head - Global Talent Partner at Global Recruitz Hiring for a reputed Insurance Company in the Middle East.Location : Dubai / Oman Job Role : Head - Medical and Life Insurance Claims Role Brief : The Head of Medical is responsible for leading the medical insurance underwriting, operations and claims functions, ensuring a robust risk management framework that aligns with organizational goals and profitability targets. This role will oversee the complete life cycle of underwriting and claims processing for medical insurance products, employing innovative solutions to optimize efficiency and accuracy. The position is critical for developing strategies that balance risk, customer satisfaction, and compliance in a rapidly evolving insurance market.Accountable for the financial performance of medical underwriting and claims, including loss ratio management and cost containment.Key Metrics: Proper underwriting practices , Underwriting profitability ratio ,Medical claims settlement efficiency Customer relationship / satisfaction and retention, Regulatory and compliance performance for both medical and life insurance lines.KRA's : - Lead medical insurance underwriting and claims strategies, aligning with company goals and regulations.- Drive innovation using AI and machine learning to improve underwriting accuracy and claims processing.- Collaborate with senior leadership to integrate medical underwriting into broader business strategy.- Oversee medical claims lifecycle to ensure timely and fair settlements.- Implement fraud detection systems and claims automation technologies.- Manage high-value and complex life and medical claims escalations.- Develop and implement medical underwriting guidelines balancing risk and profitability.- Lead risk assessment for underwriting of individual and group policies.- Utilize predictive analytics to enhance risk assessment and decision-making.- Ensure compliance with regulatory requirements for underwriting and claims processing.- Work with compliance teams to align processes with solvency and AML rules.- Build relationships with healthcare providers, reinsurers, and brokers.- Coordinate with internal stakeholders to integrate claims and underwriting.- Operate within a regulated insurance environment adhering to laws and data protection standards.- Address complex medical insurance issues, cross-border claims, and advanced treatments.Core Competencies Strategic Leadership: Ability to lead large, cross-functional teams in underwriting and claims operations.Technical Expertise: Expert knowledge of medical insurance underwriting and claims management., understanding of underwriting principles, including mortality risk, policy riders, and life insurance product design is preferred.Data Analytics & Technology: Proficiency in utilizing predictive analytics for medical underwriting decisions.Knowledge of emerging AI and automation technologies for streamlining medical claims.Knowledge Areas: Regulatory Knowledge: Comprehensive knowledge of Medical insurance regulations, including solvency requirements, policyholder protection laws.Healthcare Systems: Familiarity with global healthcare systems and medical terminologies relevant to medical insurance.Experience: Minimum 12-15 years of experience in the insurance industry, with at least 10 years in medical underwriting and claims management roles.Proven leadership in medical insurance product management, claims operations, and risk assessment.Demonstrated success in leading digital transformation initiatives related to claims and underwriting processes Seniority level Seniority level Mid-Senior level Employment type Employment type Full-time Job function Job function Administrative, Management, and Strategy/Planning Industries Insurance, Insurance Agencies and Brokerages, and Insurance Carriers Referrals increase your chances of interviewing at Global Recruitz by 2x Sign in to set job alerts for “Head of Department” roles.Dubai, Dubai, United Arab Emirates 1 year ago AVP – Head of Sharia Consultation and Documentation Operations Director - Leasing & Facilities Maintenance (Real Estate)Deputy Head of Department

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