Health Management Specialist

Job description

The role focuses on managing employee medical insurance services, handling work injuries, and coordinating healthcare activities while ensuring compliance with regulatory requirements and company policies. • Manage medical insurance programs in accordance with Council of Health Insurance (CHI) regulations. • Coordinate insurance approvals, coverage inquiries, escalations, and monitor medical coverage limits. • Review, validate, and process employee medical expense claims per company policies. • Manage social insurance registration and reporting for all work‑related injury cases. • Coordinate pre‑employment medical examinations for new hires. • Ensure quality and effectiveness of healthcare providers, including company clinics and external medical facilities. • Conduct field visits to hospitals and medical facilities to monitor service quality and compliance with accredited standards. • Arrange medical travel for employees requiring specialized treatment inside and outside the Kingdom

Requirements

• proficient in Microsoft Office
• proficient in Excel
• proficient in Word
• proficient in PowerPoint
• proficient in Outlook
• proficient in English
• knowledge of Human Resources
• knowledge of insurance systems
• teamwork
• problem solving
• experience with GOSI platform
• patient service experience
• knowledge of medical terminology
• experience in hospitals and healthcare sector
• strong communication and stakeholder management skills
• analytical thinking
• time management, planning and organization
• integrity
• care
• ownership
• accountability
• customer focus
• service excellence

Skills

Benefits

• knowledge of Council of Health Insurance (CHI) regulations
• coordination of medical insurance and provider management
• Maintain accurate records of employee medical insurance and healthcare.
• Support employees with medical insurance inquiries and healthcare service requirements.