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Maaden

Medical services Section Head

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Job Description

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 costeffective insurance management, excellent employee healthcare experience, and highquality clinic operations.

Key Responsibilities

  • Insurance Finance & Governance
  • Manage insurance renewals, negotiations, and audits.
  • Monitor loss ratio and implement costcontrol 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 preemployment 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

  • 812+ years in medical services administration, health insurance/TPA management, or clinical operations, including 35 years in a leadership role.
  • Proven track record in insurance renewals/negotiations, lossratio management, provider contracting, and multisite clinic operations.

Skills

  • Strong knowledge of insurance and clinical operations.
  • Vendor and contract management.
  • Data analysis and reporting.
  • Excellent communication in Arabic and English.

More Info

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About Company

Job ID: 135681827