Section Head, Adjudication Unit - Medical Strategy and Development

Daman - National Health Insurance Company - Abu Dhabi, UAE

Job Description

The MSD department is responsible for driving and supporting strategy and decision making across DAMAN by adjudication expertise, advances analytics and performance and quality management. The Adjudication Unit within the MSD Department is chiefly responsible for further professionalizing the medical decision making at Daman. These activities start withresearching medical best practices and writing guidelines for medical coverage based on such best practices in conjunction with the boundaries of the insurance products. The unit is responsible for the process of aligning decision making across all Daman units, including medical, underwriting and sales unit to a unified coverage practice and for the CMiE program - the Continued Medical insurance Education program within Daman. It is also heavily involved in the development of new medical strategies as described above.

Main Tasks:
• Perform research on medical best practices
• Write guidelines for medical coverage
• Align decision making across all Daman units, including medical, underwriting and sales unit to a unified coverage practice
• Steer theCMiE program - the Continued Medical insurance Education program within Daman
• Develop new medical strategies and project leadership
• Lead a team of highly skilled, young physicians that have an exemplary function in the company

Skills

• Strong execution and leadership skills
• Innovative/out-of-the box thinker
• Project management skills and some prior management role
• Good interpersonal skills with excellent commandof written and spoken English (Arabic a plus)
• Ability to lead and inspire a team of experts and to transfer knowledge

Experience Required:
• Experience with health insurance and its processes
• Certification in medical coding systems (CPT-4, ICD-9, …) is a plus
• Experience as Consultant in family medicine with more than 10 years of experience (clinicallicense to practice in a mature market expected, HAAD license a plus)

Education

Degree in Medicine

About This Company

Daman, the first and largest specialized national health insurance company to be formed in the United Arab Emirates, was established in September, 2005. Soon after its establishment, Munich Re was named the strategic partner of Daman, a venture representing a milestone in the history of health care for the Emirate of Abu Dhabi and the United Arab Emirates. Daman’s experienced professionals, diverse products, personalized service and the use of the latest information systems allow us to perform at international standards. Daman’s proactive approach to improving the quality of your health care is embedded in everything we do.