Section Head, Adjudication Unit – Medical Strategy and Development

Daman Health
Abu Dhabi, UAE

Ref: LP648-24
Daman Health

The Role


The Role


The MSD department is responsible for driving and supporting strategy and decision making across DAMAN by adjudication expertise, advances analytics and performance and quality management. The Adjudication Unit within the MSD Department is chiefly responsible for further professionalizing the medical decision making at Daman. These activities start withresearching medical best practices and writing guidelines for medical coverage based on such best practices in conjunction with the boundaries of the insurance products. The unit is responsible for the process of aligning decision making across all Daman units, including medical, underwriting and sales unit to a unified coverage practice and for the CMiE program - the Continued Medical insurance Education program within Daman. It is also heavily involved in the development of new medical strategies as described above.

Main Tasks:
• Perform research on medical best practices
• Write guidelines for medical coverage
• Align decision making across all Daman units, including medical, underwriting and sales unit to a unified coverage practice
• Steer theCMiE program - the Continued Medical insurance Education program within Daman
• Develop new medical strategies and project leadership
• Lead a team of highly skilled, young physicians that have an exemplary function in the company

Requirements


Requirements


Skills
• Strong execution and leadership skills
• Innovative/out-of-the box thinker
• Project management skills and some prior management role
• Good interpersonal skills with excellent command of written and spoken English (Arabic a plus)
• Ability to lead and inspire a team of experts and to transfer knowledge

Experience Required:
• Experience with health insurance and its processes
• Certification in medical coding systems (CPT-4, ICD-9, …) is a plus
• Experience as Consultant in family medicine with more than 10 years of experience (clinicallicense to practice in a mature market expected, HAAD license a plus)

About the Company


About the Company


A milestone in the history of health care within the UAE; Daman was formed on the 26th September, 2005 and became the UAE’s first specialized National Health Insurance Company.

Daman was initially established to cater to the growing health insurance market in the UAE, whilst maintaining exclusive direct access to the many public providers in Abu Dhabi. Daman offers a wide range of technical products with added benefits, extended policy limits and wider geographical coverage. Through a broad global provider network, Daman offers its clients complete comprehensive solutions as required by combining technical and basic products.
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