Project Manager Leader

1 week ago

Dubai, Dubai, United Arab Emirates NEXTCARE Claims Management LLC Full time

Job Description

The Electronic Platforms Project Manager role at NEXTCARE Claims Management LLC is a critical position responsible for efficiently managing and overseeing electronic transitions and reforms, including regulatory projects related to medical provider management. The focus is on electronic post office systems across the GCC and extended MEA regions.

This role is responsible for ensuring the successful execution of electronic claims processes, aligning them with business objectives, compliance standards, and local regulatory requirements within established timelines.

Key Responsibilities

  • Manage the transition of regulatory platforms, ensuring compliance with local laws and overseeing the integration and optimization of regulatory systems within the scope of Medical Provider Management.
  • Possess comprehensive knowledge of local regulations related to e-platforms and their implications, with responsibility for managing E-transformation, pricing, and cost impact within the scope of Medical Provider Management.
  • Lead and manage regulatory projects related to medical provider management and electronic post office systems.
  • Review, analyze, and ensure the alignment of electronic claims processes with business objectives and compliance standards.
  • Attend seminars, workshops, and training sessions organized by local regulatory bodies to stay updated on regulatory changes and ensure proper implementation on the relevant platforms.
  • Collaborate with stakeholders to develop business cases and ensure seamless project execution.
  • Travel across the GCC and extended regions as required for assigned E-transformation projects.
  • Support the implementation of objectives and drive the strategy set by the MPM.
  • Work closely with internal teams and relevant regulators to ensure timely and successful project delivery.
  • Oversee the quality of code mapping for price lists to ensure a cost-neutral impact when transitioning from traditional claims to electronic claims.
  • Monitor project progress, identify potential risks, and implement risk mitigation strategies.
  • Maintain detailed records of project activities, progress, and outcomes within MPM scope.
  • Provide regular updates to management on the status of all assigned projects.
  • Ensure compliance with all relevant local regulatory guidelines and standards.
  • Provide training and guidance to teams on coding standards.

About You

  • Extensive knowledge of local regulatory e-platforms and their functionalities.
  • Strong communication and project management skills.
  • Bachelor's degree in Healthcare Management, Business Administration, Project Management, or a related field.
  • Certification in Coding (CPC, CCS, CIC, COC, CCA, HCPCS).
  • 3-5 years proven experience in project management, particularly in electronic claims platform and regulatory projects.
  • In-depth knowledge of electronic claims processes and medical coding systems.
  • Deep understanding of local regulatory e-platforms and their implications.
  • Strong analytical, problem-solving, and critical-thinking skills.
  • Ability to collaborate effectively with stakeholders across departments and manage cross-functional teams.
  • Exceptional communication and interpersonal skills.
  • Logical thinking mindset and ability to solve problems.
  • Fluent in written and verbal English and Arabic; other languages are an advantage.

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