Qureos Mentor

The National Insurance Company – Daman

<div>
 
 
 Role Purpose
 
 
 <ul>
 <li>
 Offer superior customer services in key client premises with all core processes and the value added on the spot services like visit visa, individual basic, Thiqa etc.
 </li>
 <li>
 Efficiently monitor TAT for each application/endorsement request/issues handled and submitted to the concerned department
 </li>
 <li>
 Promote, sell and process individual Top-Up policies [Thiqa and Sahtak] end-to-end on spot
 </li>
 <li>
 Coordinate with relevant Daman departments such as Underwriting, Finance, Claims, PRD to ensure efficient daily operations for key client members
 </li>
 <li>
 Prepare business reports and share it on periodic basis with the key clients
 </li>
 <li>
 Collate quarterly feedback and report customer satisfaction results
 </li>
 <li>
 Work on multiple systems, processes and workflows to accomplish business needs
 </li>
 <li>
 Enrol, endorse or renew members end to end by verifying multiple required documents, and take appropriate decisions day-to-day on members&rsquo; eligibility, fines calculation, coverage period, etc.
 </li>
 <li>
 Register and process application, issue policy, create members and generate invoices and export information to produce deliverables like cards, certificate, statements etc.
 </li>
 <li>
 Ensure quality and compliance standards as per the regulatory guidelines defined for various types of business scenarios such as Individual basic, Small investors, Aounak, Domestic helpers sponsored by UAE nationals/expats, Employer-employee relationship, MOL list, WPS for salary proofs, corporate groups and brokers etc.
 </li>
 <li>
 Meet and exceed daily, weekly, monthly productivity and TAT targets, monthly quality targets, attend and complete monthly quiz with good score
 </li>
 <li>
 Understand and apply checklists and guidelines provided to achieve quality targets in daily activities. Rectify data and process gaps observed and curb repeated errors
 </li>
 <li>
 Receive and respond to phone/emails from customers/brokers on time within TAT and ensure quality communication to internal and external customers
 </li>
 <li>
 Handle customer queries by providing accurate, valid and complete information by using the right methods and tools and follow up until the issue is resolved
 </li>
 <li>
 Register customer complaints, find solution or escalate to the respective units and follow up until resolved and ensure TAT
 </li>
 </ul>
 
 
 Key Requirements and Qualifications
 
 
 <ul>
 <li>
 Any English language certification is a plus
 </li>
 <li>
 UAE Driving license is a plus
 </li>
 <li>
 Bachelor&rsquo;s degree in any field
 </li>
 </ul>
 
 
</div>

Coordinator, Key Client Services ( UAEN) - Dubai

<div>
 
 
 Role Purpose
 
 
 
 To manage all aspects of administration and servicing of AXA Daman customers, including provision of approvals, processing of claims, placing overseas Guarantees of Payment (GOPs), and supporting customers with enquiries on their policies via calls and emails.
 
 
 
 Key Responsibilities
 
 
 <ul>
 <li>
 Customer Support &amp; Claims Handling
 </li>
 <li>
 Handle customer-facing tasks such as emails, calls, and overseas GOP placements.
 </li>
 <li>
 Manage escalations (e.g., delayed or declined pre-approvals, PBM, and reimbursement claims) and resolve during the first contact where possible.
 </li>
 <li>
 Cross-train on multiple tasks (RI claims, approvals, PBM override, membership tasks) to ensure quick resolution and first contact resolution.
 </li>
 <li>
 Offer value-added services such as Virtual Doctor and Mind Health.
 </li>
 <li>
 Ensure Stella feedback (global customer feedback tool) is shared after each customer interaction.
 </li>
 </ul>
 
 
 Operational &amp; Internal Support
 
 
 <ul>
 <li>
 Support Daman Operations team with queries on policy, pre-approval, and claims adjudication.
 </li>
 <li>
 Communicate with insured members and brokers on claims and requests, escalating to Daman team when necessary.
 </li>
 <li>
 Liaise with internal departments to ensure smooth scheme operations.
 </li>
 <li>
 Maintain confidentiality of all medical information.
 </li>
 <li>
 Perform ad-hoc tasks assigned by the manager.
 </li>
 </ul>
 
 
 Knowledge &amp; Business Understanding
 
 
 <ul>
 <li>
 Strong knowledge of medical policy wordings, insurance and billing policies.
 </li>
 <li>
 In-depth understanding of medical conditions, treatments, and procedures to support claims guidance and provider discussions.
 </li>
 <li>
 Knowledge of medical insurance platform structures and interaction between Daman and AGH.
 </li>
 <li>
 Awareness of competitors and their product offerings.
 </li>
 <li>
 Proficiency in IT systems (Word, Excel, data entry, reporting, data extraction, statistical analysis).
 </li>
 </ul>
 
 
 Decision-Making &amp; Judgment
 
 
 <ul>
 <li>
 Exercise sound judgment to ensure one-call resolution for customer queries
 </li>
 <li>
 Manage and prioritize multiple functional tasks within agreed turnaround times (TAT).
 </li>
 <li>
 Build and maintain positive working relationships between Daman and AXA.
 </li>
 </ul>
 
 
 
 
 
 
 
 
 Minimum Requirements
 
 
 <ul>
 <li>
 Tertiary education in Clinical or Paramedical field (degree required).
 </li>
 <li>
 Minimum 2 years in a clinical/paramedical field.
 </li>
 <li>
 Preferably with customer-facing experience.
 </li>
 <li>
 Strong interpersonal and communication skills.
 </li>
 <li>
 Effective planning, organization, and time management.
 </li>
 <li>
 Customer-focused with the ability to motivate others.
 </li>
 <li>
 Positive and adaptable to different cultures.
 </li>
 <li>
 Operational management.
 </li>
 <li>
 Customer centricity.
 </li>
 <li>
 Coaching and motivational skills.
 </li>
 <li>
 Strong analytical and problem-solving ability.
 </li>
 <li>
 Workload management and prioritization.
 </li>
 </ul>
 
 
</div>

Officer, IPMI Operations ( Nursing qualification)

<div>
 
 We are seeking a highly skilled and dynamic Business Analyst to join our department within the Business Relations team. This role is crucial in bridging the gap between our business objectives and technological solutions. The Business Analyst will play a pivotal role in understanding the evolving needs of our internal and external partners and customers, translating these into clear requirements, and collaborating with IT and other stakeholders to deliver solutions that drive operational efficiency, enhance customer experience, and ensure regulatory compliance within the complex insurance landscape.
 
 
 
 
 
 
 Responsibilities
 
 
 <ul>
 <li>
 Elicit and Analyse Requirements: Conduct comprehensive requirements gathering through interviews, workshops, surveys, and document analysis to capture functional and non-functional needs, business rules, and process flows.
 </li>
 <li>
 Process Modelling and Optimization: Analyse current state business processes to identify inefficiencies, design optimized future state processes, and develop clear process maps (e.g., BPMN).
 </li>
 <li>
 Data Analysis &amp; Reporting: Interpret complex data sets to uncover insights, identify trends, and develop actionable reports to support strategic decision-making for business relations initiatives.
 </li>
 <li>
 Solution Assessment &amp; Validation: Evaluate the feasibility of proposed solutions, facilitate User Acceptance Testing (UAT), define test scenarios, and ensure developed solutions align with business needs.
 </li>
 <li>
 Stakeholder Collaboration: Serve as a key liaison between business stakeholders, IT teams, and external partners, ensuring clear communication, consensus building, and effective expectation management throughout the project lifecycle.
 </li>
 <li>
 Customer/Partner Journey Mapping: Analyse and map the end-to-end journeys of various customer and partner segments to identify pain points and opportunities for improvement.
 </li>
 <li>
 Support Regulatory Adherence: Ensure that all defined requirements and proposed solutions adhere to relevant insurance regulations and compliance guidelines.Stay updated on relevant market trends and incorporate them into strategic decision-making.
 </li>
 </ul>
 
 
 
 
 
 Qualifications
 
 
 
 
 
 <ul>
 <li>
 Minimum of 3-5 years of experience as a Business Analyst, preferably within the Insurance or financial services industry.
 </li>
 <li>
 Bachelor's degree in Business Administration, Finance, Insurance, or a related field.
 </li>
 <li>
 Demonstrated experience with full Software Development Life Cycle (SDLC) methodologies, with a strong preference for Agile (Scrum, Kanban) environments.
 </li>
 <li>
 Proven track record of working closely with diverse business and technical teams.
 </li>
 <li>
 Knowledge of key market trends and their impact on the insurance industry.
 </li>
 <li>
 Business Analysis Professional
 </li>
 <li>
 Competency in Business Analysis
 </li>
 <li>
 Agile certifications (e.g., Certified Scrum Product Owner - CSPO)
 </li>
 <li>
 Relevant professional certifications (e.g., CBAP, PMP) are preferred.
 </li>
 </ul>
 
 
 
 
 
 Skills and Competencies
 
 
 
 
 
 <ul>
 <li>
 Core Business Analysis: Mastery of requirements elicitation, documentation, scope management, process modelling (BPMN), data analysis, and solution validation (UAT support).
 </li>
 <li>
 Excellent Communication &amp; Interpersonal Skills: Exceptional active listening, verbal, written, and presentation skills to effectively convey complex information to diverse audiences.
 </li>
 <li>
 Stakeholder Management: Proven ability to build strong relationships, manage expectations, and resolve conflicts with internal and external stakeholders.
 </li>
 <li>
 Problem-Solving &amp; Critical Thinking: Highly analytical mindset with the ability to break down complex problems, identify root causes, propose practical, solution-oriented, and strategic solutions.
 </li>
 <li>
 Adaptability &amp; Resilience: Ability to thrive in a dynamic, fast-paced environment, embrace change, and maintain effectiveness under pressure.
 </li>
 <li>
 Negotiation &amp; Persuasion: Skilled in building consensus and influencing stakeholders to adopt optimal solutions and changes.
 </li>
 <li>
 Business Relations Context: Strong understanding of partner ecosystems (brokers, agents, healthcare providers), customer journey mapping, and familiarity with insurance systems.
 </li>
 <li>
 Insurance Domain Expertise: In-depth understanding of insurance products (health, life, property, casualty), core insurance processes (underwriting, claims, policy administration), and the regulatory landscape (DOH, DHA, local guidelines).
 </li>
 <li>
 Technology Acumen: Solid understanding of SDLC/Agile methodologies, system integration concepts (APIs, data warehousing), and proficiency with project management tools (Jira, Confluence), requirement management tools. Basic to intermediate SQL skills are a plus.
 </li>
 <li>
 Attention to Detail: Meticulous accuracy and thoroughness in all aspects of analysis, documentation, and validation..
 </li>
 </ul>
</div>

Assistant Manager, IT Business Relations (Analyst)

<div>
 
 
 Role Purpose:
 
 
 
 
 
 <ul>
 <li>
 Liaise between HIS and other business functions to assure effective delivery of existing HIS services and functionality
 </li>
 <li>
 Build relationship with the process owners and business functions by developing a communication process to keep up to date on initiative and project status
 </li>
 <li>
 Solely responsible for a specific area e.g. end-to-end, cross departmental processes
 </li>
 <li>
 Elicit requirements using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, business analysis, and task and workflow analysis
 </li>
 <li>
 Critically evaluate information gathered from multiple sources, reconcile conflicts, decompose high-level information into details, abstract up from low-level information to a general understanding, and distinguish user requests from the underlying true needs
 </li>
 <li>
 Proactively communicate and collaborate with external and internal customers to analyze information needs and functional requirements and deliver the following artefacts as needed: User story Business Case Business Requirements Document Use Cases Screen and Interface designs
 </li>
 <li>
 Prepare training material and provide training to train the trainers.
 </li>
 <li>
 Engage stakeholders in support of initiatives.
 </li>
 <li>
 Work independently with users to define concepts and under direction of the Account Managers
 </li>
 <li>
 Drive and challenge business units on their assumptions of how they will successfully execute their objectives.
 </li>
 <li>
 Work with project teams and business to develop user acceptance test criteria with the business during the solving phase.
 </li>
 <li>
 Participate/lead review and final sign off of functional specifications.
 </li>
 <li>
 Maintain business process map for key processes.
 </li>
 <li>
 Log initiatives in JIRA and Confluence and keep the status up to date.
 </li>
 <li>
 Continually provide application systems improvements, especially in cross-business processes
 </li>
 <li>
 Identify ways to increase adoption and customer satisfaction
 </li>
 </ul>
 
 
 
 
 
 Key Requirements and Qualifications
 
 
 
 
 
 <ul>
 <li>
 Minimum 5 years of relevant experience
 </li>
 <li>
 Bachelor&rsquo;s degree in business, IT/Computer Engineering or Finance or Human Resources Administration or Medicine or other related fields
 </li>
 <li>
 Prior consulting/business analysis experience is must.
 </li>
 <li>
 Functional consultant experience in Oracle EBS and good knowledge in AP and AR modules
 </li>
 <li>
 Proficiency in MS office (MS word, Excel, PowerPoint)
 </li>
 <li>
 Proficiency in process modelling tools such as Visio, BPMN
 </li>
 </ul>
 
 
 
 
 
 Skills and Competencies
 
 
 
 
 
 <ul>
 <li>
 Strong understanding of project management and agile methodologies
 </li>
 <li>
 Ability to document and diagram use cases, systems &amp; business processes.
 </li>
 <li>
 Strong level of customer service orientation and professionalism in all interactions
 </li>
 <li>
 Strong facilitation and presentation skills.
 </li>
 <li>
 Very good command of written and spoken English; Knowledge of Arabic language is an advantage
 </li>
 <li>
 Ability to handle multiple projects in a fast-paced environment.
 </li>
 <li>
 Effective communication and stakeholder management skills.
 </li>
 <li>
 Excellent problem solving and analytical skills.
 </li>
 <li>
 Good knowledge of health insurance concepts is added advantage
 </li>
 </ul>
 
 
</div>

Assistant Manager, Business Relations (Finance)

<div>
 
 
 General:
 
 
 <ol>
 <li>
 The Specialist, Medical Economics Optimization is responsible for conducting comprehensive analyses of medical cost, pharmacy, and revenue data to identify trend drivers and affordability opportunities.
 </li>
 <li>
 Understand the Daman strategy and business decisions to support managers in making informed, fact-based decisions.
 </li>
 <li>
 Access, manage, and perform complex queries; analyse and interpret data; prepare information assets and data extracts.
 </li>
 <li>
 Develop and maintain distinctive expertise in specific analytical tools such as SQL, or Excel, Power BI and others demonstrating independence and proactivity.
 </li>
 <li>
 Work closely with clinical teams, network, IT departments, and other stakeholders to ensure accurate data collection, reporting, and implementation of cost optimization and improvement strategies.
 </li>
 </ol>
 
 
 
 
 
 Medical Economics
 
 
 
 
 Performance Metrics Development:
 
 
 <ol>
 <li>
 Develop and maintain affordability and policy analysis queries to measure the performance of the business and the financial impact of DoH standards/policies.
 </li>
 <li>
 Generate regular reports on performance metrics, including utilization and unit cost trends and areas of concern for internal and external stakeholders
 </li>
 </ol>
 
 
 
 
 
 Data Analysis and reporting:
 
 
 <ol>
 <li>
 Perform data reporting and analysis of recurring and ad-hoc report requests.
 </li>
 <li>
 Support the leadership team with initiative and health outcomes reports.
 </li>
 </ol>
 
 
 
 
 
 Dashboard Management:
 
 
 <ol>
 <li>
 Develop dashboards using Power BI for Provider Network, Clinical Quality and Disease Management programs.
 </li>
 <li>
 Update the dashboards to ensure they accurately reflect current performance data and trends.
 </li>
 <li>
 Customize dashboards to meet the needs of various stakeholders and facilitate data-driven decision-making.
 </li>
 </ol>
 
 
 
 
 
 Data Management:
 
 
 <ol>
 <li>
 Maintain accurate and up-to-date business portfolio performance databases and records.
 </li>
 <li>
 Utilize data management tools and software to streamline data collection, analysis, and reporting processes.
 </li>
 <li>
 Ensure data management procedures and projects adhere to established timelines and processes.
 </li>
 <li>
 Act as the point of contact for external vendors to optimize the technical operations of database management and dashboards.
 </li>
 <li>
 Collaborate with the ITS department to improve IT systems and act as a focal point for reporting issues.
 </li>
 </ol>
 
 
 Key Requirements and Qualifications
 
 
 <ul>
 <li>
 Minimum 5 years of experience in healthcare data extraction and clinical performance analysis
 </li>
 <li>
 Proficiency in data analysis tools and software (e.g. Excel, SQL, Statistical Analysis software, PowerBI, Tableau)
 </li>
 <li>
 Experience working with CPT, ICD 10 &amp; DRG coding systems.
 </li>
 <li>
 Ability to work collaboratively with multidisciplinary teams.
 </li>
 <li>
 Excellent communication and presentation skills.
 </li>
 <li>
 Bachelor&rsquo;s degree required; strongly preferred fields are related to Computer Science or Programming, Statistics or Mathematics, Health Economics or Healthcare Management
 </li>
 <li>
 Master&rsquo;s degree is preferred
 </li>
 </ul>
 
 
 
 
 
 Skills and Competencies
 
 
 <ul>
 <li>
 Must have SQL/SAS Analytics experience; hold solid analytical skills and data mining aptitude
 </li>
 <li>
 Advanced Microsoft Office Applications and Power BI
 </li>
 <li>
 Advanced quantitative and analytical skills such as regression analysis, time series analysis and inferential statistics
 </li>
 <li>
 Strong attention to detail and high degree of speed and accuracy
 </li>
 <li>
 Excellent communication, reporting, presentation, negotiation and interpersonal skills
 </li>
 <li>
 Good knowledge of health care analytics with background knowledge of various medical cost blocks and trends (e.g., pharmacy, laboratory, DRG&rsquo;s, E&amp;M etc.)
 </li>
 <li>
 Very good command of written and spoken English; knowledge of Arabic language is an advantage
 </li>
 <li>
 Very good planning, forecasting, execution and problem-solving skills
 </li>
 <li>
 Results oriented whilst ensuring high quality of work
 </li>
 </ul>
 
 
</div>

Specialist, Medical Economics Optimization