Job Description
Job Title
Medical services Section Head
Department / Function
Employee Relations (ER), Contract Management (CM) and Medical Services
Reports To
Manager, ER, CM and Medical Services (Turki Rashed AlSuhaimi)
Location
Riyadh, KSA
Purpose
Lead the Medical Services Department to ensure cost‑effective insurance management, excellent employee healthcare experience, and high‑quality clinic operations.
Key Responsibilities
- Insurance Finance & Governance
- Manage insurance renewals, negotiations, and audits.
- Monitor loss ratio and implement cost‑control measures.
- Ensure insurer compliance with contracts and SLAs.
- Insurance Operations & Employee Support
- Oversee policy administration (additions/deletions).
- Handle rejected cases and coordinate with hospitals and insurer for best care.
- Review and approve medical reimbursements.
- Contract providers for pre‑employment medical checks.
- Clinics Management
- Supervise company clinics and ensure quality service.
- Manage vendor performance, invoices, and pharmacy operations.
- Promote health awareness and occupational health programs.
Qualifications
- Licensed by Saudi Commission for Health Specialties (GP or higher).
- BLS certification (mandatory).
- Preferred: Occupational Health certification.
Experience
- 8–12+ years in medical services administration, health insurance/TPA management, or clinical operations, including 3–5 years in a leadership role.
- Proven track record in insurance renewals/negotiations, loss‑ratio management, provider contracting, and multi‑site clinic operations.
Skills
- Strong knowledge of insurance and clinical operations.
- Vendor and contract management.
- Data analysis and reporting.
- Excellent communication in Arabic and English.
