Qureos Mentor

MedNet Egypt L.L.C

<div>
 
 
 MedNet Egypt
 
 is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled
 
 &ldquo;Project Manager.&rdquo;
 
 This role is responsible for leading regional digital transformation and process automation initiatives that leverage AI within health insurance operations. Support initiatives such as digital claims management, improvements to members and provider portals, the automation of manual processes, and AI-driven solutions (e.g., fraud detection, auto-adjudication, chatbots).
 
 
 
 
 
 
 Your Job
 
 
 
 
 
 <ul>
 <li>
 Lead digital and automation projects such as e-Claims and e-Preauthorization workflows, AI-based claims adjudication or fraud analytics, Member/provider self-service platform enhancements, Document digitization and intelligent routing.
 </li>
 <li>
 Develop and manage comprehensive project plans, timelines, risk logs, and business cases with defined success metrics for post-implementation evaluation.
 </li>
 <li>
 Coordinate and align cross-functional teams across markets, including operations, IT, provider relations, and medical review units, to ensure successful project execution
 </li>
 <li>
 Lead structured workshops with key stakeholders to gather business and regulatory requirements, translating them into detailed BRDs, FSDs, and user stories for UAT.
 </li>
 <li>
 Coordinate with IT application specialists to ensure accurate translation of requirements into solution design and successful solution delivery.
 </li>
 <li>
 Document comprehensive business requirements, including:
 </li>
 <li>
 Health Claims Adjudication Logic
 </li>
 <li>
 Provider Network Management Needs
 </li>
 <li>
 Regulatory Compliance Requirements
 </li>
 <li>
 Workflow Automation and Exception Handling
 </li>
 <li>
 Conduct discovery and feasibility analysis to identify automation opportunities using AI and RPA technologies such as chatbots, intelligent document processing, and predictive analytics.
 </li>
 <li>
 Collaborate with data teams, developers, and architects to design and develop intelligent automation solutions.
 </li>
 <li>
 Prepare business cases with ROI analysis and lead the implementation of automation platforms like RPA, OCR, and NLP to minimize manual work.
 </li>
 </ul>
 
 
 
 
 
 
 
 
 Your Profile
 
 
 
 
 
 <ul>
 <li>
 Bachelor's degree, ideally in industrial engineering or business administration, economics, or a similar qualification.
 </li>
 <li>
 Good knowledge of Microsoft applications, particularly profound experience developing PowerPoint presentations, Excel sheet models, and MS Project.
 </li>
 <li>
 Problem-solving skills and leadership skills are essential.
 </li>
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 Willingness to travel.
 </li>
 <li>
 PMP certification.
 </li>
 <li>
 Business Analysis Certification.
 </li>
 <li>
 Six sigma green belt would be a plus.
 </li>
 <li>
 
 Insurance industry PM experience (4+ years).
 
 </li>
 <li>
 Proven delivery in
 
 integrations
 
 ,
 
 regulatory/compliance
 
 (
 
 ADHICS, SOC 2, ISO
 
 ),
 
 process improvements
 
 , and
 
 portal enhancements
 
 .
 </li>
 <li>
 Tools:
 
 Jira, Smartsheet, MS Project
 
 ; advanced
 
 PowerPoint/Excel
 
 ;
 
 fluent business English
 
 .
 </li>
 <li>
 Ability to partner with
 
 Risk/Compliance
 
 and
 
 Commercial
 
 ; experience
 
 applying AI tools
 
 to PM deliverables.
 </li>
 <li>
 Good knowledge and experience in project management tools and methodologies, Business requirement documentation, and process re-engineering.
 </li>
 </ul>
 
 
</div>

Project Manager

<div>
 
 
 MedNet Egypt
 
 is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled
 
 ETL Data Analyst
 
 who will be responsible for designing, building, and maintaining robust data pipelines that support claims processing, financial reporting, regulatory submissions, provider analytics, and operational dashboards across the TPA ecosystem.
 
 
 
 
 
 
 Your Job
 
 
 <ul>
 <li>
 Design, develop, optimize, and maintain ETL workflows.
 </li>
 <li>
 Build automated ingestion pipelines for claims, remittance, eligibility, membership, provider files, and policy data.
 </li>
 <li>
 Ensure efficient transformations, data cleansing, deduplication, and quality checks.
 </li>
 <li>
 Develop scheduling, monitoring, and alerting mechanisms.
 </li>
 <li>
 Integrate data from claims engines, network systems, PA engines, finance systems, and insurer portals.
 </li>
 <li>
 Map heterogeneous data sources into unified analytical models.
 </li>
 <li>
 Support API‑ and SFTP‑based data exchanges with insurers and providers.
 </li>
 <li>
 Implement data validation rules for completeness and accuracy.
 </li>
 <li>
 Identify anomalies across claims, PA, member, policy, and provider datasets.
 </li>
 <li>
 Enhance data lineage and metadata management.
 </li>
 <li>
 Work with Data Analysts, BI developers, Operations, Medical, Finance, IT, and Compliance teams.
 </li>
 <li>
 Translate business rules into automated ETL logic.
 </li>
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 Provide root‑cause analysis for data issues.
 </li>
 <li>
 Tune ETL jobs for scalability, speed, and stability.
 </li>
 <li>
 Optimize SQL queries, indexing, and data partitioning.
 </li>
 <li>
 Ensure minimal downtime for critical data pipelines.
 </li>
 </ul>
 
 
 
 
 
 
 
 
 Your Profile
 
 
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in Computer Science, Information Systems, or related field.
 </li>
 <li>
 1-3 years ETL/data engineering experience, ideally in TPA or health insurance.
 </li>
 <li>
 Strong experience in building scalable ETL pipelines.
 </li>
 <li>
 Strong ETL tool experience (SSIS, Informatica, Talend, ADF, etc.).
 </li>
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 SQL (advanced), including query optimization.
 </li>
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 Data warehousing concepts and dimensional modeling.
 </li>
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 Experience with APIs, JSON/XML, and SFTP automation.
 </li>
 <li>
 Python, Bash, or PowerShell scripting.
 </li>
 <li>
 Cloud experience (Azure/AWS/GCP) preferred
 </li>
 </ul>
 
 
</div>

ETL Developer

<div>
 
 
 MedNet Egypt
 
 is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled
 
 Data Governance Specialist
 
 who will be responsible for establishing, implementing, and maintaining a comprehensive data governance framework across the organization. The role ensures that enterprise data is accurate, consistent, secure, compliant, and strategically aligned with business needs, particularly across claims, prior authorization, membership, provider, and financial domains.
 
 
 
 
 
 
 Your Job
 
 
 
 
 
 <ul>
 <li>
 Develop and maintain enterprise data governance policies, standards, and procedures.
 </li>
 <li>
 Define data ownership, stewardship models, classification standards, and data lifecycle rules.
 </li>
 <li>
 Establish governance processes supporting the data warehouse and analytics ecosystem.
 </li>
 <li>
 Define enterprise data quality KPIs.
 </li>
 <li>
 Implement data quality monitoring and issue resolution processes.
 </li>
 <li>
 Lead root-cause analysis and continuous improvement initiatives across domains.
 </li>
 <li>
 Build and maintain an enterprise business glossary and data dictionary.
 </li>
 <li>
 Maintain metadata repositories and data lineage maps.
 </li>
 <li>
 Ensure consistency in terminology and KPI definitions.
 </li>
 <li>
 Ensure data practices comply with regulatory and internal security requirements.
 </li>
 <li>
 Partner with Compliance and IT Security to manage access controls and retention policies.
 </li>
 <li>
 Support audits and readiness activities.
 </li>
 <li>
 Work closely with Data Engineering to embed governance rules into pipelines.
 </li>
 <li>
 Collaborate with BI teams to standardize reporting and KPI definitions.
 </li>
 <li>
 Ensure governance alignment across operational, medical, network, and finance functions.
 </li>
 </ul>
 
 
 
 
 
 Your Profile
 
 
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in Data Management, Information Systems, Computer Science, or related field.
 </li>
 <li>
 1 to 3 years of experience in data governance or related roles.
 </li>
 <li>
 Experience in health insurance or TPA environments preferred.
 </li>
 <li>
 Strong understanding of data governance frameworks (e.g., DAMA principles).
 </li>
 <li>
 Knowledge of data warehousing, ETL processes, and BI environments.
 </li>
 <li>
 Experience with metadata and data quality tools.
 </li>
 <li>
 Familiarity with structured and unstructured data flows.
 </li>
 <li>
 Understanding of health insurance operations, claims, authorizations, and provider data.
 </li>
 </ul>
</div>

Data Governance Specialist

<div>
 
 
 MedNet Egypt
 
 is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled
 
 Business Reporting
 
 
 Analyst
 
 who will be responsible for supporting medical insurance operations by transforming raw operational and financial data into actionable insights.
 
 
 
 
 
 
 
 Your Job
 
 
 <ul>
 <li>
 Build, maintain, and enhance reports and dashboards.
 </li>
 <li>
 Perform detailed analysis on claims submissions, adjudication outcomes, provider billing, remittance cycles, and prior authorization requests.
 </li>
 <li>
 Conduct trend analysis, SLA monitoring, utilization studies, and cost insights.
 </li>
 <li>
 Extract and model data from OBIEE (Oracle BI), Power BI, and Excel.
 </li>
 <li>
 Clean, reconcile, and transform medical insurance datasets into business‑ready models.
 </li>
 <li>
 Work extensively with claims submission data, remittance advice structures, and prior approval requests.
 </li>
 <li>
 Understand claim life‑cycle workflows, provider payment processes, and operational TATs.
 </li>
 <li>
 Monitor data accuracy and escalate discrepancies.
 </li>
 <li>
 Support automation initiatives and collaborate with IT, Operations, Medical, and Finance teams.
 </li>
 </ul>
 
 
 
 
 
 
 
 
 Your Profile
 
 
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in a relevant field or equivalent experience
 </li>
 <li>
 1&ndash;3 years&rsquo; experience in health insurance analytics or business reporting
 </li>
 <li>
 Advanced Power BI and Excel skills
 </li>
 <li>
 Experience with OBIEE (Oracle BI)
 </li>
 <li>
 Good command of English
 </li>
 <li>
 SQL knowledge
 </li>
 <li>
 Healthcare or medical insurance domain exposure
 </li>
 <li>
 Automation or reporting optimization experience
 </li>
 <li>
 Strong analytical and structured thinking
 </li>
 </ul>
 
 
</div>

Business Reporting Analyst

Join MedNet Egypt L.L.C and explore 4   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

MedNet Egypt L.L.C

About Company

Project Manager

ETL Developer

Data Governance Specialist

Business Reporting Analyst