Intelligent Solutions HR Consultancy Hiring for Director – Medical Strategy Job at Dubai Full Time

Our Client is a leading Insurance Specialist who are looking for a Director of Medical Strategy. This role reports into the Chief Medical Officer.

• Develop the Company’s medical strategy
• Lead health insurance cost containment programmes
• Develop initiatives supporting patients in improving their lifestyle sustainably
• Review and improve medical quality of services provided
• Develop and implement control & prevention of error and waste activities
• Develop best practice guidelines to standardise internal medical decisions
• Build and maintain key relationships with regulatory authorities; oversee and ensure regulatory compliance and handle regulatory requests

Mandate of Medical Strategy Department:

Disease Management & Population Health:

• (Re-)Design and implement (via outsourcing to providers) tailored Chronic Disease Management programmes
• Determine, monitor and review medical improvement KPIs for members enrolled in a Chronic Disease Management programme
• Develop and administer tailored Community/Health Wellness and Outreach campaigns to help members improve their lifestyle sustainability
• Run a population Health Quality programme for provider medical quality of care, including research studies with DOH

Medical Value Management:

• Oversee health insurance cost containment programme and coordinate the implementation of medical strategic direction across the CMOO units
• Develop and implement control & prevention of error and waste activities; develop best practice guidelines to standardise internal medical decisions
• Accountability for medical and business adjudication engines which act as a pre-requisite for standardisation and automation, with overall accountability for the combined rules engine lying with the Head of Medical Operations
• Leverage data to identify & analyse abnormal spikes in utilisation at clinician/provider & policy level

Regulatory Affairs:

• Monitor DOH-Comms
• Handle all regulatory complaints (IA/DHA/DoH) submitted against the Company
• Handle all VIP complaints (CPC/GSEC/EWAA/Humanitarian) submitted against the Company
• Build and maintain relationships with regulatory authorities through meetings and negotiations
• Provide strategic and technical support/advice incl. commercially
• Submit all medical regulatory reports as required under the regulations

• Develop and implement department strategy following the Company’s strategy, set departmental and operational goals and initiate measures to reach goals and to improve department performance
• Accountable for a result-oriented management considering cross-departmental performance/results
• Manage and develop people and resources including provision of a strong leadership presence
• Manage department expenditure and requirements minding the impact on the financial budget
• Foster organisational culture by establishing quality awareness and service orientation and obeying consistent implementation of processes such as Project and Change Management
• Lead and influence the development, implementation and adherence of policies and procedures

Department Specific:

• Consult with management on strategies to manage the cost of health insurance
• Manage and lead cost containment initiatives
• Advise on opportunities for department cost containment and efficiency (cost centre management)
• Advise on the conceptualisation, research and creation of new programmes matching the need of the community in line with the Company strategy and goals
• Oversee the creation, outlining and review of contents of all Community Health programmes with regards to the clinical KPIs and pathways
• Advise the design and outsourcing of a range of Disease Management programmes for various chronic diseases to healthcare providers
• Ensure the preparation and delivery of medical management information as per internal requests related to medical cost containment
• Advise on suitable improvement initiatives and ensure adequate management/support of these
• Advise and monitor new strategic medical initiatives in business development, i.e. provide medical information for decision making process, (co-)design strategy/concept and manage implementation
• Manage handling of all regulatory and VIP complaints submitted against the Compan
• Lead negotiations and meetings with regulatory authorities to build and maintain positive relationships
• Ensure submission of all required medical regulatory reports

Requirements

• Minimum 8 years of experience in management level with high level of managerial skills and relevant experience in healthcare counselling
• Qualified Medical Practitioner
• Bachelor’s degree in Healthcare Administration, Medicine or any relevant field
• Courses in Business Administration and Healthcare Management are a plus
• Master’s degree in Health Services Administration is a plus

Skills & Competencies:

• Deep knowledge and experience in utilizing and developing tools, concepts and strategies that leverage new business opportunities with strong business understanding and background
• Deep knowledge of data management, analysis and management reporting standards, statistics, process improvement methodologies and insurance processes
• Detailed working knowledge of healthcare networks
• Energetic, entrepreneurial, self-starter and capable of self-direction
• Strategic thinking with strong focus on results and high quality of work
• Very good leadership skills including people management, selection and development skills
• Excellent analytical, planning, forecasting, execution and problem-solving skills