Medical & Claims Operations Leader

MedNet Global Healthcare Solutions LLC; Manama; On-site; BHD 30,000 - 60,000; Full time

Job summary

MedNet Bahrain is seeking a Manager - Medical & Claims to lead our medical authorizations and claims operations, ensuring high-quality, efficient, and customer-centric service across authorizations, claims adjudication and medical governance.

The role requires strong leadership, clinical expertise and a proven ability to optimize medical costs while maintaining compliance with regulatory requirements and service standards.

Qualifications

• Medical degree and active license to practice.
• Minimum 6 years of clinical practice with at least 3 years in TPAs/health insurance or managed care.
• Proven leadership of operational or medical teams.
• Strong understanding of health insurance operations, authorizations, and claims adjudication.

Responsibilities

• Lead Medical Authorizations and Claims teams to deliver high performance and KPIs.
• Oversee medical authorizations review for alignment with guidelines and policy terms.
• Manage end-to-end claims operations including timely settlement.
• Drive cost containment through utilization management and evidence-based decisions.
• Ensure SLAs and quality metrics are met and governance frameworks observed.
• Build relationships with clients, insurers, providers and stakeholders.
• Lead continuous improvement and staff development.

Skills

Clinical leadership

Stakeholder management

Analytical thinking

Communication skills

Education

Medical Degree (WHO-recognized university)

Job description

MedNet Bahrain is seeking a Manager - Medical & Claims to lead our medical authorizations and claims operations, ensuring high-quality, efficient, and customer-centric service across authorizations, claims adjudication and medical governance.

The role requires strong leadership, clinical expertise and a proven ability to optimize medical costs while maintaining compliance with regulatory requirements and service standards.