Specialist, Health Management

Ma'aden; Riyadh; On-site; SAR 60,000 - 90,000; Full time

Job summary

Ma'aden seeks a qualified Health Insurance Administrator to manage employee medical insurance services, claims, and provider coordination within Riyadh. You will ensure regulatory compliance and support employees with their medical needs.

Responsibilities include CHI compliance, GOSI registration, and coordination of pre-employment medicals, while maintaining accurate records and liaising with clinics and external facilities.

Qualifications

• Bachelor’s degree in healthcare administration, Business Administration, Human Resources, or related field.
• Minimum 2 years of experience in medical insurance administration/healthcare support.
• Knowledge of CHI regulations and GOSI processes.

Responsibilities

• Manage employee medical insurance programs and compliance with CHI regulations.
• Coordinate insurance approvals, coverage inquiries, and claims processing.
• Maintain medical records and support employee healthcare needs.
• Oversee GOSI registration and reporting for work-related injuries.
• Coordinate pre-employment medical examinations for new hires.
• Liaise with healthcare providers and monitor service quality.

Skills

CHI regulations

GOSI Platform

Patient service

Medical terminology

Insurance coordination

Provider management

MS Office

communication

analytical thinking

time management

English proficiency

Education

Bachelor’s degree in healthcare administration or related field

Tools

GOSI system

Health insurance platforms

Job description

JOB DESCRIPTION

Manage and administer employee medical insurance services, work injury processes, and healthcare coordination activities while ensuring compliance with regulatory requirements and company policies. The role supports employees’ medical needs through effective insurance administration, claims management, healthcare provider coordination, and occupational health compliance.

Key Accountabilities

• Administer employee medical insurance programs in compliance with Health Insurance Council (CHI) regulations.
• Coordinate insurance approvals, coverage inquiries, escalations, and monitoring of medical coverage limits.
• Review, validate, and process employee medical expense claims in accordance with company policies.
• Manage GOSI registration, reporting, and follow-up for all work-related injury cases.
• Coordinate pre-employment medical examinations for new hires.
• Maintain accurate medical insurance and employee healthcare records.
• Support employees with medical insurance inquiries and healthcare service requirements.
• Ensure quality and effectiveness of healthcare providers, including company clinics and external medical facilities.
• Conduct site visits to hospitals and medical facilities to monitor service quality and compliance with approved healthcare standards.
• Coordinate medical travel arrangements for employees requiring specialized treatment within and outside the Kingdom.

Minimum Qualifications

• Bachelor’s degree in healthcare administration, Business Administration, Human Resources, or a related field.

Minimum Experience

• Minimum 2 years of experience in medical insurance administration, healthcare services, employee medical support, or a related healthcare field.

Skills

• Knowledge of Health Insurance Council (CHI) Regulations
• GOSI Platform Management
• Patient Service Experience and Employee Medical Support
• Knowledge of Medical Terminology
• Medical Insurance Coordination and Provider Management
• Hospital and Healthcare Industry Experience
• Microsoft Office (Excel, Word, PowerPoint, Outlook)
• Strong Communication and Stakeholder Management Skills
• Analytical Thinking and Problem Solving
• Time Management, Planning, and Organization
• English Language Proficiency

Competencies

• Teamwork
• Integrity
• Care
• Ownership
• Communication
• Accountability
• Customer Focus
• Analytical Thinking
• Problem Solving
• Planning and Organizing
• Service Excellence