Job Description

The Position:

We are seeking a highly organized and detail-oriented person to lead and oversee the eligibility management function within our policy administration division. This role is critical in ensuring the accurate, timely, and efficient processing of eligibility data, aligning with regulatory requirements and organizational standards.

Main Duties/Responsibilities:

Lead and manage the eligibility operations team, overseeing day-to-day activities related to member and policy eligibility setup, maintenance, and validation.

Develop, implement, and refine procedures for eligibility verification, data integrity, and customer support in alignment with policy guidelines.

Ensure compliance with local insurance regulations (e.g., DHA, DOH, CBUAE) and internal company policies.

Collaborate with underwriting, claims, IT, and customer service teams to streamline workflows and resolve eligibility-related issues.

Monitor performance metrics (e.g., turnaround times, accuracy rates) and implement continuous improvement initiatives.

Liaise with group and individual clients for accurate data submission and eligibility clarification.

Supervise the processing and updating of group policy data, endorsements, renewals, and cancellations.

Manage the integration of eligibility data with digital platforms and core insurance systems (e.g., policy administration system, CRM).

Lead training, mentoring, and performance management for the eligibility operations team.

Prepare regular reports and insights for senior management on policy and eligibility operations performance.

Your Profile:

Bachelor's degree in business administration, Insurance, or related field (Master's preferred).

Minimum of 5 years of experience in insurance operations, with at least 3 years in a managerial or supervisory role.

Proven experience in eligibility operations or policy administration in health insurance.

Strong understanding of UAE insurance regulations and industry standards.

Familiarity with core insurance systems and data management tools.

Excellent leadership, communication, and stakeholder management skills.

Strong analytical thinking and problem-solving abilities.

Experience working with regulatory portals (e.g., DHA, HAAD, ICP, Riayati, etc).

Proficiency in Excel and insurance software platforms.

Bilingual proficiency (Arabic and English) is a plus.

Certification in insurance (e.g., CII, HIA, LOMA) is desirable.

Job Type: Full-time

Pay: AED9,000.00 - AED11,000.00 per month