Strategic Operations Transformation Lead - Pre-Auth & CXE

Bupa Arabia; Riyadh; On-site; SAR 250,000 - 400,000; Full time

Job summary

Bupa Arabia in Saudi Arabia seeks a capable lead to manage Pre-Auth protocols, operating processes, and Bupa Pro project execution within contracted providers. You will ensure adherence to defined medical guidelines and policy standards while focusing on CXE, cost control, and member safety.

You will drive capability building, ensure regulatory compliance with SAMA and CHI, and guide the PA team to deliver high-quality medical adjudication and decision making in line with Bupa values.

Qualifications

• Minimum 3 years in medical insurance/administrative field.
• Minimum 2 years in medical/clinical practice.
• Experience as GP/ER/Family Medicine.
• Proven leadership and analytical abilities.
• Crisis management experience.
• Strong understanding of CHI and SAMA guidelines.

Responsibilities

• Oversee pre-authorisation protocols and medical cost management.
• Ensure compliance with Bupa, CHI, and SAMA regulations.
• Lead provider management to optimize CXE and cost control.
• Develop and monitor performance metrics and reporting.
• Coach and develop PA team members.

Skills

Medical insurance management

Leadership

Analytical skills

Crisis management

Healthcare operations

Policy compliance

Job description

Bupa Arabia in Saudi Arabia seeks a capable lead to manage Pre-Auth protocols, operating processes, and Bupa Pro project execution within contracted providers. You will ensure adherence to defined medical guidelines and policy standards while focusing on CXE, cost control, and member safety.

You will drive capability building, ensure regulatory compliance with SAMA and CHI, and guide the PA team to deliver high-quality medical adjudication and decision making in line with Bupa values.