Qureos Mentor

Transguard Workforce Solutions

<div>
 
 Transguard Workforce Solutions is the UAE&rsquo;s leading provider of unique and innovative HR solutions. With a decade of experience in the region and a team that possesses extensive knowledge of the market, we provide a fully integrated HR solution.
 
 
 
 
 
 We are currently recruiting for a
 
 Specialist - IT Governance &amp; Risk
 
 for our client to be based out of Abu Dhabi.
 
 
 
 
 
 
 Purpose-
 
 
 
 
 
 
 Ensures that IT processes, services and operations are aligned with business objectives, regulatory requirements, and best practices. Manage IT-related risks, maintain compliance with national/international standards, manage audits and contribute to decision-making that supports IT Governance and IT goals.
 
 
 
 
 
 
 Responsibility-
 
 
 
 
 
 <ul>
 <li>
 Develop, implement, maintain IT governance framework including IT policies, processes, guidelines, standards and ensure KPIs are defined and monitored to ensure IT systems and processes are aligned with business strategies and regulatory requirements.
 </li>
 <li>
 Develop, implement, maintain the IT Risk Assessment framework along with risk mitigation strategies and risk response planning as well conduct risk assessments aligned to regulatory requirements and international standards.
 </li>
 <li>
 Continuously monitor risk exposure and update risk management strategies as necessary.
 </li>
 <li>
 Prepare risk reports and metrics for management reporting and compliance requirements.
 </li>
 <li>
 Represent the IT Department as the ERM champion.
 </li>
 <li>
 Conduct regular audits and assessments to identify gaps in compliance and ensure corrective actions are taken.
 </li>
 <li>
 Support in IT&rsquo;s internal and external audits and ensure effective management reporting of same.
 </li>
 <li>
 Responsible for ensuring compliance to ISO 27001:2022, ISO 20000:2018, Cyber Security Council, TDRA, and other government and regulatory requirements, in coordination with respective stakeholders.
 </li>
 <li>
 Develop long-term IT roadmaps and ensure IT strategies are scalable, sustainable, and support future business growth, in alignment with Authority&rsquo;s goals and objectives.
 </li>
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 Identify emerging technologies, trends, and innovations that can enhance the Authority&rsquo;s IT capabilities, providing recommendations for strategic initiatives.
 </li>
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 Excellence and the Alignment with the Government requirements
 </li>
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 Provide specialized reports to senior leadership maintain government enablers KPIs results and work on planning and implementing the government requirements.
 </li>
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 Participate in benchmarking activities for the department and provide overall report to the IT Director.
 </li>
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 Monitor and review internal controls for effectiveness and identify areas for improvement, fostering a culture of continuous improvement within the IT governance and risk management processes.
 </li>
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 Lead and oversee projects aimed at improving IT governance, risk management, compliance, and business continuity efforts.
 </li>
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 Provide expert technical advisory and recommendations on IT technologies and innovations to improve business performance, efficiency, and security.
 </li>
 </ul>
 
 
 
 
 
 Skills-
 
 
 
 
 
 <ul>
 <li>
 A bachelor&rsquo;s degree in IT with 5 years&rsquo; experience in a similar function, or Masters&rsquo; degree with 3 years&rsquo; experience, or as defined in the JD Matrix.
 </li>
 <li>
 Relevant certifications (e.g., CISSP, CISA, ITIL, ISO 27001, ISO 20000, CCSK etc.) are highly desirable.
 </li>
 <li>
 Hands-on experience with IT governance frameworks, risk management methodologies, and regulatory compliance standards.
 </li>
 <li>
 Experience in project management, preferably with certification in project management methodologies.
 </li>
 <li>
 Skilled in the development and implementation of IT policy and standards and IT process
 </li>
 <li>
 Excellent knowledge of managing risks and designing business continuity plans.
 </li>
 </ul>
</div>

Specialist - IT Governance & Risk  (2 Year Contract)

<div>
 
 
 Transguard Workforce Solutions
 
 is the UAE&rsquo;s leading provider of unique and innovative HR solutions. With a decade of experience in the region and a team that possesses extensive knowledge of the market, we provide a fully integrated HR solution.
 
 
 We are currently recruiting a
 
 Senior Officer E-Claims
 
 for our client based in Abu Dhabi, UAE.
 
 
 
 
 
 
 Job Purpose:
 
 
 
 The job holder is responsible for receiving and reviewing medical claims as assigned by the supervisor, ensuring timely and accurate processing in line with insurance policies, company standards, and regulatory guidelines. They are also expected to handle walk-in customers professionally, providing clear and satisfactory responses. Within their delegated authority, they must process claims with diligence and accountability, while identifying and escalating any suspicious patterns or potential abuse by providers to the supervisor.
 
 
 
 
 
 
 Job Description:
 
 
 <ul>
 <li>
 Reviewing claims for medical necessity, coding accuracy (ICD, CPT, CDT), and compliance with pre-authorization and tariff agreements.
 </li>
 <li>
 Approving or rejecting claims within delegated authority, with proper documentation and denial codes.
 </li>
 <li>
 Escalating suspicious or invalid claims to supervisors.
 </li>
 <li>
 Ensuring adherence to SLAs, audit standards, and continuous process improvement.
 </li>
 <li>
 Generating reports and contributing to policy updates and cost containment initiatives.
 </li>
 </ul>
 
 
 
 
 
 Job Requirements:
 
 
 <ul>
 <li>
 Degree in Medicine, Dentistry, Pharmacy, Nursing, or Paramedics
 </li>
 <li>
 CPC/AHIMA certification preferred
 </li>
 <li>
 3-5 years of relevant experience in the UAE required.
 </li>
 <li>
 Proficient in English and medical coding standards
 </li>
 </ul>
 
 
</div>

Senior Officer E-Claims

Join Transguard Workforce Solutions and explore 2   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.

Transguard Workforce Solutions

About Company

Specialist - IT Governance & Risk (2 Year Contract)

Senior Officer E-Claims