𝐊𝐞𝐲 𝐑𝐞𝐬𝐩𝐨𝐧𝐬𝐢𝐛𝐢𝐥𝐢𝐭𝐢𝐞𝐬:Identify, assess, and monitor operational, medical, claims, financial, fraud, and compliance risks.
Conduct risk assessments and identify potential areas of exposure across operations.
Develop and recommend appropriate risk mitigation measures and controls.
Monitor claims-related risks, including fraud, waste, and abuse (FWA).
Assess provider and operational risks and highlight potential areas requiring corrective action.
Support compliance with applicable UAE insurance and health authority requirements.
Monitor relevant regulatory and compliance requirements, including CBUAE, DHA, and DOH requirements.
Prepare risk reports and provide insights to management on identified risks and mitigation actions.
Support audits, risk reviews, and ongoing risk-monitoring activities.
𝐐𝐮𝐚𝐥𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬 & 𝐄𝐱𝐩𝐞𝐫𝐢𝐞𝐧𝐜𝐞:Bachelor’s degree in Insurance, Risk Management, Finance, Healthcare Administration, Business Administration, or a related field.
3–5 years of experience in insurance or health insurance, preferably within a insurer, or claims management organization.
Experience in risk assessment, claims risk, fraud/waste/abuse, provider risk, and operational risk.
Knowledge of UAE health insurance regulations and CBUAE/DHA/DOH requirements is preferred.
Strong analytical, reporting, audit, and risk-monitoring skills.
Professional certification such as CII, IRM, CRMA, or equivalent is an advantage.
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