Policy Validation Lead

The Cigna Group; Riyadh; On-site; SAR 150,000 - 200,000; Full time

Job summary

A leading healthcare organization in Riyadh is looking for an individual to manage policy contract implementations and member services. The role requires a Bachelor’s or Master’s degree and a minimum of 3 years in Business/IT management, focusing on digital transformation. Candidates should possess strong leadership skills, experience in the healthcare or insurance industry, and be fluent in English and Arabic. Join us in enhancing lives and driving growth in the healthcare sector.

Qualifications

• 3+ years of experience in Business / IT management.
• Proven track record in digital transformation.
• In-depth knowledge of digital technologies and cybersecurity.

Responsibilities

• Manage client membership lists and validate with Yakeen.
• Handle fallouts and prepare compliance information.
• Build and implement policy contracts.
• Communicate with clients about duplicate insurance.
• Arrange compliance documents for policy validation.
• Implement uploads on global care system.
• Prepare daily reports on new/renewal policies.

Skills

Leadership

Team management

Digital transformation

Project management

Organizational skills

Fluent in English

Fluent in Arabic

Education

Bachelor’s or Master’s degree in related field

Job description

Purpose

This key objective of the role is to initiate all activities as directed by the Manager in ensuring policy contract implementation and members within the agreed KPI .

Key Responsibilities

• Working directly with clients(new & retention) on membership list & validating with Yakeen to achieve 100% upload within 48 hours & minimizing fallout below 1% (excluding duplicate insurance) after client confirmation.
• Fallouts: Working directly with clients to manage fallouts & arrange compliance information for successful CHI upload.
• Contracts: Building & implementing policy contracts when requested.
• Duplicate Insurance: Communicate with clients on the status of duplicate insurance & implement client decision with upload to CHI within 15 days.
• Policy validation: Arranging required compliance documents & information to confirm policy validation.
• Global care: Implementation of policy / member upload on global care system.
• Misc.: Any related tasks on membership / policy assigned by Manager.
• Report: Prepare daily status report on new / renewal policies & fallouts

Qualifications

• Bachelor’s or Master’s degree in related field.
• Minimum of 3 years of experience in Business / IT management, with a proven track record in digital transformation.
• Strong leadership and team management skills.
• In-depth knowledge of the latest digital technologies and cybersecurity practices.
• Experience in the insurance or healthcare industry, preferably in the Middle Eastern market.
• Excellent project management and organizational skills.
• Fluent in English and Arabic.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.