Medical Core System Transformation Lead

Al Futtaim Private Company (LLC); Dubai; On-site; AED 350,000 - 550,000; Full time

Job summary

Al Futtaim Private Company (LLC) is seeking a Transformation Leader to design and drive a medical core system transformation program. You will own outcomes, timelines and value realization across claims, pricing, provider networks and utilization management, with a focus on API-driven modernization.

Collaborating with Medical Operations, Finance, Compliance, and IT, you will translate strategy into a phased roadmap, manage multi-workstream delivery, and ensure regulatory alignment and secure,

Qualifications

• 12+ years of experience in health insurance, payer operations, or healthcare technology.
• Proven leadership of large-scale core system transformation programs in medical insurance.
• Deep understanding of claims, benefits, pricing, provider networks, and utilization management.
• Experience modernizing legacy platforms to configurable APIs or SaaS solutions.
• Ability to work with enterprise architects, security, and data teams.

Responsibilities

• Lead strategy design and execution of the medical core system transformation program.
• Own business outcomes, timeline, and value realization.
• Partner with clinical, operations, and IT teams to align workflows and regulatory needs.
• Oversee vendor engagements and ensure security and compliance.
• Establish governance, milestones, risks, and change readiness.

Skills

Leadership

Stakeholder management

Program governance

Health insurance domain knowledge

API-based integration

Change management

Strategic thinking

Job description

Transformation Leadership

Lead the strategy design and execution of the medical core system transformation program. Act as the single point of accountability for business outcomes, timeline and value realization. Translate enterprise strategy into a clear transformation roadmap, phased migration MVPs, and decommissioning.

Core Medical Systems Ownership

Own transformation across key medical domains including Claims adjudication and paymentPolicy, benefits configurationProvider and network managementAuthorizations and utilization managementMedical pricing rules and payment logic. Drive modernization from monolithic legacy platforms to configurable API-driven core solutions.

Business Clinical Alignment

Partner with Medical Operations Finance Actuarial Compliance and Provider Relations teams. Ensure business rules, clinical workflows and regulatory requirements are accurately digitized. Resolve trade-offs between standard product capability vs local customization.

Vendor Partner Management

Lead engagement with core system vendors, system integrators and niche solution providers. Oversee solution design deployment quality and contractual commitments. Govern vendor delivery to ensure alignment with architecture security and compliance standards.

Governance Delivery Execution

Establish program governance including milestones, dependencies and risks. Manage multi-workstream delivery technology, data, business readiness, migration and change. Ensure transformation is delivered with minimal disruption to ongoing business operations.

Regulatory Compliance Readiness

Ensure core systems meet health insurance regulatory payer and data privacy requirements. Support audits, reporting and compliance validation through system design and controls.

Change Adoption Value Realization

Drive business adoption through process redesign, training and change management. Define and track value realization metrics: speed, cost, accuracy and scalability. Enable future capabilities such as analytics, automation and AI-driven operations.

Essential Experience

• 12+ years of experience in health insurance, payer operations, or healthcare technology.
• Proven leadership of large-scale core system transformation programs in medical insurance.
• Deep understanding of medical claims, benefits, pricing, provider networks, and utilization management.
• Experience modernizing legacy medical core platforms to modern or SaaS-based solutions.
• Technical & Domain ExpertiseStrong knowledge of health insurance core systems (claims/PAS/medical modules).Experience with system migration, data conversion, and parallel run strategies.Understanding of API-based integration, interoperability, and data architecture.Comfort working with enterprise architects, security, and data teams.
• Leadership & Ways of WorkingStrong stakeholder management across business, clinical, technology, and vendors.Ability to lead through ambiguity and make pragmatic trade-offs.Executive-level communication and decision facilitation skills.
• Outcome-oriented mindset with strong delivery discipline.

What equips you for the role

• Core medical system migration delivered on time and within agreed scope.
• Reduction in claims processing time, errors, and manual interventions.
• Improved configurability of medical benefits and pricing.
• Measurable improvement in member and provider experience.
• Safe decommissioning of legacy platforms and technical debt reduction.