69 Insurance Management jobs in Saudi Arabia

Description

Reporting to the Operations Manager, this lead position will be responsible for oversight and governance of the Operational Compliance function, including supervising responsibilities of the team. The Compliance function will be a critical area within Operations that will drive the activation of group insurance policies based on a complex review of our clients and customers, including risk assessments of their company profile and accuracy of data provided. The role requires key communication skills in order to partner with various teams across the organization and provide solutions for issues and ongoing improvements.

**Responsibilities**:
Plan and coordinate the operational activities to guarantee compliance with local Laws and Regulations.
Set targets and measure performance
Own responsibility of escalations and issues related to the team
Provide extensive support and guidance to Regional and International teams on Middle East compliance queries and requirements.
Govern compliance data gathering and validation activities on regular basis
Maintain issue log to identify gaps and opportunities for process improvements.
Support with internal and external audits
Stays updated with the regulatory requirement with the changes and impart inter-department training when needed.
Closely partner with regional sales and client management teams to provide advice, support and guidance on all regulatory and compliance matters.
Support the teams to identify all compliance risks, help gather missing information and avoid non-compliance cases.
Establish and maintain relationships with key stakeholders

Experience & Competencies

Minimum Bachelor's degree
Excellent English and Arabic written and oral communication skills
People management and reporting experience
Exceptional organizational and time-management focus
Independently responds to inquiries, grievances, complaints, or appeals ranging from routine to severe complexity.
High proficiency in MS office, excel in particular
Great rapport building and communication skills
Strong problem solving, leadership skills, analytical and decision-making skills
Minimum of 3 years’ experience of the Middle East insurance market and its associated risks

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

This is a broad and general role that will get involved in a range of compliance activities, with the view to specialize as the role evolves. The compliance officer will support the Middle East region, giving great exposure to a range of products and business units. You are expected to help deliver the compliance monitoring programme ensuring the business is meeting regulatory requirements and all policies, procedures and systems are in line with company compliance plan.

**Responsibilities**:
Perform below duties; to ensure that all policies and procedures are implemented and well documented.

Plan and coordinate the operational activities to guarantee compliance with local Laws and Regulations.
Provide extensive support and guidance to Regional and International teams on Middle East compliance queries and requirements.
Undertake compliance data gathering and validation activities on regular basis based on agreement level.
Maintain issue log to identify gaps and opportunities for process improvements.
Conduct periodic internal audit, identify problem areas and help formulate strategy to maintain compliance status.
Stays updated with the regulatory requirement with the changes and impart inter-department training when needed.
Closely partner with regional sales and client management teams to provide advice, support and guidance on all regulatory and compliance matters.
Registration of benefit plans on government portals
Support with preparation and management of client and broker contracts
Support the teams to identify all compliance risks, help gather missing information and avoid non-compliance cases.
Monitor and report adherence of compliance practice across business.
Establish and maintain relationships with key stakeholders

Experience & Competencies

Minimum Bachelor's degree
High proficiency in MS office, excel in particular
Great rapport building and communication skills
Strong problem solving, leadership skills, analytical and decision-making skills
Minimum of 3 years’ experience of the Middle East insurance market and its associated risks

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

JOB PURPOSE
The job holder is responsible for member level details in the internal system. He/She will be responsible for any endorsement requests, queries and issues related on member level to be completed within the agreed turn around time.
2. RESPOSIBILITIES AND DUTIES
- Handle day to day activities related to Member endorsements - Addition, Deletion, Update requests.
- Validate and process requests as per Regulatory Guidelines, Standard Operating Procedures and Business Processes in line with agreed KPI/TAT.
- Upload member documents in Compliance repository for future audit and review.
- Acknowledge and confirm completion of requests via ticketing portal.
- Issue welcome packs and card as required.
- Audit and Print physical medical cards as required.
- Generate reports related to the Membership and Policy card details.
- Provide resolution to inquiries related to membership endorsements.
- Interact with different departments and coordinate to bring issue to a resolution.
- Provides the highest levels of services in Policy Administration
- Responsibility and accountability for service levels, turnaround times and quality.
- Escalate to Team Leader any substandard requirements, deviations and delays in data uploading.
- Identifies potential process improvements and make recommendations to the organization.
- Actively support team members and provides resource to enable all team goals to be achieved.
- Perform adhoc tasks as assigned by Supervisor.

3. QUALIFICATIONS
- Bachelor’s degree
- 0 to 2 years of experience with data entry, preferably in Medical Insurance
- Analytical skills - must be able to review data and identify any potential issues or discrepancies
- High attention to details.
- Must be able to conduct computer data entry.
- Excellent written and oral communication skills.
- Proven ability to work independently as well as a productive member of a team.
- Exceptional organization and time-management focus.

4. COMPETENCIES
- Conflict Management - Sees opportunities within conflicts arising; reads situation quickly; engages in focused listening; can hammer out tough agreements and settle disputes equitability; can find common ground and get cooperation with minimum disruption.
- Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; Gets first-hand customer information and uses it for improvements in products and services; Acts with customers in mind; Establishes and maintains effective relationships with customers and gains their trust and respect
- Dealing with Ambiguity - Can effectively cope with change; can shift gears comfortably. Can decide and act without having the total picture. Doesn’t have to finish things before moving on. Can comfortably handle risk and uncertainty.

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

JOB PURPOSE
The job holder is responsible for updating policy records in the internal system to ensure the group policy is showing the correct status and level in order for the members to have access to care. He/She will be responsible for the end-to-end Account Installation process including setting up of benefits, group details, contacts, rates, pricing, member records and card requirements.
2. RESPOSIBILITIES AND DUTIES
- Interacts with different internal departments and partners in the coordination and implementation of our new and renewing accounts to effectively setup benefit plan, group and member information.
- Establishes and complies with a client specific service plan.
- Ensures that the documentation received is complete and logical as per system requirements.
- Reviews the Table of Benefits for acceptability / consistency from system requirements.
- Reviews the member census received for new policies as per regulatory compliance and system requirements.
- Reconciles census against system active list for renewal policies.
- Request for additional information based on system and compliance requirements.
- Set up benefits in the system and all its other linkages.
- Set up system with group and member details.
- Responsible for releasing member welcome pack for newly installed policy and renewed policies.
- Ensure that the group policy setup has successfully been created from partner’s system.
- Reconcile accuracy between internal and partner’s system before releasing member cards.
- Reviews mid-year policy changes and updates system as required.
- Ensure that the output required for the mid-year policy change has been coordinated within teams and released as required.
- Acts as an intermediary between internal departments and business partners in resolving daily service issues related to newly incepted/renewed group.
- Acts as Subject Matter Expert for any system related query for policies.
- Researches and resolves issues in day-to-day operations.
- Performs daily, weekly, monthly reconciliation between systems.
- Performs routine maintenance, report preparation and issue resolution with efficient book of business management through timely and proper utilization of internal tools.
- Performs other duties as assigned and maintains high quality of work.
- Provides the highest levels of services in Policy Administration.
- Monitors and manage team queue, workflow and quality of work.
- Build relationships with internal departments and partners to ensure smooth processing of client requests.
- Identifies potential process improvements and make recommendations to the organization.
- Actively support team members and provides resource to enable all team goals to be achieved.
- Responsibility and accountability for service levels, turnaround times and quality.

3. QUALIFICATIONS
- Bachelor’s degree
- 2 to 3 years of experience with data entry, preferably in Medical Insurance
- Analytical skills - must be able to review data and identify any potential issues or discrepancies
- High attention to details.
- Must be able to conduct computer data entry.
- Must be able to make recommendations which are supported by various data pulls
- Intermediate proficiency in Microsoft Office Suite specifically in Excel.
- Excellent written and oral communication skills.
- Proven ability to work independently as well as a productive member of a team.
- Exceptional organization and time-management focus.

4. COMPETENCIES
- Conflict Management - Sees opportunities within conflicts arising; reads situation quickly; engages in focused listening; can hammer out tough agreements and settle disputes equitability; can find common ground and get cooperation with minimum disruption.
- Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; Gets first-hand customer information and uses it for improvements in products and services; Acts with customers in mind; Establishes and maintains effective relationships with customers and gains their trust and respect

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

Senior Manager - Insurance Business Rules/RCM/Denial Management

Job Openings Senior Manager - Insurance Business Rules/RCM/Denial Management

About the job Senior Manager - Insurance Business Rules/RCM/Denial Management

Role Summary: Business Rules Senior Manager

• Responsible for managing the product image and its development though client Interface by connecting Content and Business teams(BDU)simultaneously.
• Ensuring and supporting the development for rules content by providing support to internal team by reviewing, guiding, and validating the activities performed in the same regard.
• Reviewing data analytics and extracting insights based on market payers, regulator protocols, claims denial trends and users feedback analysis is also a part of the role being performed.
• To ensure adherence to market billing standards and protocols, the Business Rules Sr. Manager will be expected to work closely with stakeholders like payers, regulators and healthcare providers, revenue cycle departments to analyze coding/billing issues to be compliant with regulatory policies or denials with payers in market of KSA

Primary Responsibilities:

1. Role act as a bridge between internal THYNK team and the management to communicate the vision and related development of the product.

2. Partnering with existing and potential clients to bring the vision for update to THYNK team.

3. Liaising with team regularly and reviewing the activities to support best in interest of the vision of the management.

4. Developing on functionalities that can best support product to groom as per market practice.

5. Should be able to work well under pressure and simultaneous reporting to multiple lines of management.

6. Monthly validating with analysis team and review of claim remittance reports across all the payers and simultaneous provision of feedback suggesting updates for the rule engine thereby decreasing denial trends for the clients and maximizing remittance output.

7. Regular analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation outcomes and optimizing end user experience.

8. Reviewing with internal teams clients historical denial reports establishing their trend analysis and target rules content profile to address their revenue integrity.

9. Apply effective communication skills (written and spoken) to communicate with all parties internal and external analyzing market insights and best market practice to produce accurate representation of the issues and the proposed solutions in the form of Rules Content definitions.

Job Requirements:

1. Minimum 10 years experience in the claim adjudication lifecycle and payer/TPA is a must.

2. Previous work experience with Data Analytics packages such as Power BI will be preferred.

3. Excellent Analytical skills and an eye for detail is a must.

4. Understanding of insurance adjudication guidelines and protocols in a way to comprehend best to enrich KSA Rules repository.

5. Recognized Professional Certification in Medical Coding will be a plus but not mandatory.

6. Should be well versed in KSA local market regulations and adjudication protocols.

7. Excellent verbal/written communication and presentation skills.

8. Proficiency in Healthcare Information Systems

9. Medical training as Doctor/Nurse/Pharmacist is highly desirable.

10. Certifications in Insurance and project management is highly desired

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Senior Manager - Insurance Business Rules/RCM/Denial Management

Join to apply for the Senior Manager - Insurance Business Rules/RCM/Denial Management role at SANTECHTURE

Senior Manager - Insurance Business Rules/RCM/Denial Management

Join to apply for the Senior Manager - Insurance Business Rules/RCM/Denial Management role at SANTECHTURE

Role Summary: Business Rules Senior Manager

• Responsible for managing the product image and its development though client Interface by connecting Content and Business teams(BDU)simultaneously.
• Ensuring and supporting the development for rules content by providing support to internal team by reviewing, guiding, and validating the activities performed in the same regard.
• Reviewing data analytics and extracting insights based on market payers, regulator protocols, claims denial trends and users feedback analysis is also a part of the role being performed.
• To ensure adherence to market billing standards and protocols, the Business Rules Sr. Manager will be expected to work closely with stakeholders like payers, regulators and healthcare providers, revenue cycle departments to analyze coding/billing issues to be compliant with regulatory policies or denials with payers in market of KSA
  
  

Primary Responsibilities

• Role act as a bridge between internal THYNK team and the management to communicate the vision and related development of the product.
• Partnering with existing and potential clients to bring the vision for update to THYNK team.
• Liaising with team regularly and reviewing the activities to support best in interest of the vision of the management.
• Developing on functionalities that can best support product to groom as per market practice.
• Should be able to work well under pressure and simultaneous reporting to multiple lines of management.
• Monthly validating with analysis team and review of claim remittance reports across all the payers and simultaneous provision of feedback suggesting updates for the rule engine thereby decreasing denial trends for the clients and maximizing remittance output.
• Regular analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation outcomes and optimizing end user experience.
• Reviewing with internal teams clients historical denial reports establishing their trend analysis and target rules content profile to address their revenue integrity.
• Apply effective communication skills (written and spoken) to communicate with all parties internal and external analyzing market insights and best market practice to produce accurate representation of the issues and the proposed solutions in the form of Rules Content definitions.
  
  

Job Requirements

• Minimum 10 years experience in the claim adjudication lifecycle and payer/TPA is a must.
• Previous work experience with Data Analytics packages such as Power BI will be preferred.
• Excellent Analytical skills and an eye for detail is a must.
• Understanding of insurance adjudication guidelines and protocols in a way to comprehend best to enrich KSA Rules repository.
• Recognized Professional Certification in Medical Coding will be a plus but not mandatory.
• Should be well versed in KSA local market regulations and adjudication protocols.
• Excellent verbal/written communication and presentation skills.
• Proficiency in Healthcare Information Systems
• Medical training as Doctor/Nurse/Pharmacist is highly desirable.
• Certifications in Insurance and project management is highly desired

Seniority level

• Seniority level Mid-Senior level

Employment type

• Employment type Full-time

Job function

• Job function Finance and Sales
• Industries IT Services and IT Consulting

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Senior Manager - Insurance Business Rules/RCM/Denial Management

Job Openings Senior Manager - Insurance Business Rules/RCM/Denial Management

About the job Senior Manager - Insurance Business Rules/RCM/Denial Management

Role Summary: Business Rules Senior Manager

• Responsible for managing the product image and its development though client Interface by connecting Content and Business teams(BDU)simultaneously.
• Ensuring and supporting the development for rules content by providing support to internal team by reviewing, guiding, and validating the activities performed in the same regard.
• Reviewing data analytics and extracting insights based on market payers, regulator protocols, claims denial trends and users feedback analysis is also a part of the role being performed.
• To ensure adherence to market billing standards and protocols, the Business Rules Sr. Manager will be expected to work closely with stakeholders like payers, regulators and healthcare providers, revenue cycle departments to analyze coding/billing issues to be compliant with regulatory policies or denials with payers in market of KSA

Primary Responsibilities:

1. Role act as a bridge between internal THYNK team and the management to communicate the vision and related development of the product.

2. Partnering with existing and potential clients to bring the vision for update to THYNK team.

3. Liaising with team regularly and reviewing the activities to support best in interest of the vision of the management.

4. Developing on functionalities that can best support product to groom as per market practice.

5. Should be able to work well under pressure and simultaneous reporting to multiple lines of management.

6. Monthly validating with analysis team and review of claim remittance reports across all the payers and simultaneous provision of feedback suggesting updates for the rule engine thereby decreasing denial trends for the clients and maximizing remittance output.

7. Regular analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation analysis and review of bypass reports containing feedback from end users to improve the rules logic, quality and accuracy of validation outcomes and optimizing end user experience.

8. Reviewing with internal teams clients historical denial reports establishing their trend analysis and target rules content profile to address their revenue integrity.

9. Apply effective communication skills (written and spoken) to communicate with all parties internal and external analyzing market insights and best market practice to produce accurate representation of the issues and the proposed solutions in the form of Rules Content definitions.

Job Requirements:

1. Minimum 10 years experience in the claim adjudication lifecycle and payer/TPA is a must.

2. Previous work experience with Data Analytics packages such as Power BI will be preferred.

3. Excellent Analytical skills and an eye for detail is a must.

4. Understanding of insurance adjudication guidelines and protocols in a way to comprehend best to enrich KSA Rules repository.

5. Recognized Professional Certification in Medical Coding will be a plus but not mandatory.

6. Should be well versed in KSA local market regulations and adjudication protocols.

7. Excellent verbal/written communication and presentation skills.

8. Proficiency in Healthcare Information Systems

9. Medical training as Doctor/Nurse/Pharmacist is highly desirable.

10. Certifications in Insurance and project management is highly desired

We are seeking a highly analytical and detail-oriented Risk Management Specialist to join our MVNO operations. The successful candidate will be responsible for identifying, assessing, mitigating, and monitoring risks that could impact the organization’s financial performance, compliance status, reputation, and operational resilience. The role is critical to ensuring our business continuity, data protection, regulatory compliance (e.g., CITC, GDPR), and operational excellence within a dynamic telecommunications environment.

Key Responsibilities:

• Conduct risk assessments across all MVNO business units including sales, billing, IT, customer service, and network operations.
• Identify strategic, operational, regulatory, financial, and reputational risks.
• Develop and implement risk mitigation strategies, controls, and action plans.
• Monitor the effectiveness of risk controls and recommend improvements.
• Regulatory Compliance
• Ensure compliance with local telecom regulations (e.g., CITC), data protection laws, and industry standards.
• Liaise with regulatory bodies and internal compliance teams as necessary.
• Incident Management & Business Continuity
• Develop, test, and maintain Business Continuity and Disaster Recovery Plans.
• Lead root-cause analysis and post-incident reviews of major risk events.
• Reporting & Communication
• Prepare regular risk reports and dashboards for senior management and stakeholders.
• Maintain the organization’s risk register and update it periodically.
• Collaborate with other departments (Legal, IT, Finance, etc.) to address cross-functional risks.
• Promote a risk-aware culture through training and awareness sessions.

Qualifications & Experience:

• Bachelor's degree in Risk Management, Business Administration, Finance, Telecommunications, or related field. Master’s degree is a plus.
• 5+ years of experience in risk management, preferably in the telecom or MVNO sector.
• Strong understanding of telecom-specific risks including SIM fraud, revenue assurance, network security, and regulatory compliance.
• Familiarity with risk management frameworks (ISO 31000, COSO).
• Knowledge of Business Continuity Planning (BCP), regulatory standards (CITC, GDPR), and fraud detection techniques.
• Experience with risk management tools and software is an advantage.

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Seniority level

• Seniority level Entry level

Employment type

• Employment type Full-time

Job function

• Job function Customer Service
• Industries Telecommunications

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Get notified about new Risk Management Specialist jobs in Riyadh, Saudi Arabia .

Riyadh, Riyadh, Saudi Arabia 14 hours ago

Risk Management and Business Continuity Director Enterprise Risk Management Specialist (Jubail) Governance Risk and Compliance Consultant

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Support in establishing and maintaining high oversight mechanism standards on the Investment, Treasury and Project Operations Financing portfolios of the Bank to keep a watchful eye on the performance, risk, and compliance. This is achieved through (a) effective monitoring and reporting process in close coordination with the relevant stakeholders, (b) robust internal control practices for proper fiduciary and risk oversight, and (c) smooth, streamlined, and well-designed processes to proactively manage risks including quality assurance, systems and tools, monitoring & data, and proper reconciliation with the Bank’s financials. The incumbent shall possess strong IT skills and the ability to work with databases and files to ensure that a solid foundation of consistent data is in place and contribute to developing robust reconciliation, monitoring, and reporting tools.

Key Accountabilities

Corporate Middle Office (CMO)

1. Support the independent valuation function on OCR and other funds.
2. Monitor the security and collateral/guarantees valuations and the Loan to Value (LTV) ratio on a periodic basis.
3. Provide support in developing robust tools to ensure data integrity, reconciliation for consistency across the systems and the Bank financial statements; and assist in establishing a series of regular reports (on performance, risk, and compliance) on Bank-wide portfolios (Investments, Treasury, and Operations).
4. Maintenance and custody of risk management master data and ensure unique identification for obligor across all relevant systems.
5. Ensure that the relevant IsDB databases are accurately and timely updated.
6. Propose and implement process improvements to increase efficiency, effectiveness, and compliance of the related operations.
7. Contribute to the automation of the CMO process for time-saving and minimizing operational risks.

Academic and Professional Qualifications

Bachelor's degree in Economics/Finance/Risk Management/Mathematics/Business Administration or related discipline.

Minimum 3 years of relevant experience in the Banking industry.

Skills & Necessary Knowledge

Analytical Thinking.

Languages

French - Preferred.

About Application Process

If you meet the criteria and you are enthusiastic about the role, we would welcome your application. To complete the application, you would need the following document(s):

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