MedNet Egypt is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled Project Manager. This role is responsible for leading regional digital transformation and process automation initiatives that leverage AI within health insurance operations. Support initiatives such as digital claims management, improvements to members and provider portals, the automation of manual processes, and AI-driven solutions (e.g., fraud detection, auto-adjudication, chatbots).
Your Job
- Lead digital and automation projects such as e-Claims and e-Preauthorization workflows, AI-based claims adjudication or fraud analytics, Member/provider self-service platform enhancements, Document digitization and intelligent routing.
- Develop and manage comprehensive project plans, timelines, risk logs, and business cases with defined success metrics for post-implementation evaluation.
- Coordinate and align cross-functional teams across markets, including operations, IT, provider relations, and medical review units, to ensure successful project execution
- Lead structured workshops with key stakeholders to gather business and regulatory requirements, translating them into detailed BRDs, FSDs, and user stories for UAT.
- Coordinate with IT application specialists to ensure accurate translation of requirements into solution design and successful solution delivery.
- Document comprehensive business requirements, including:
- Health Claims Adjudication Logic
- Provider Network Management Needs
- Regulatory Compliance Requirements
- Workflow Automation and Exception Handling
- Conduct discovery and feasibility analysis to identify automation opportunities using AI and RPA technologies such as chatbots, intelligent document processing, and predictive analytics.
- Collaborate with data teams, developers, and architects to design and develop intelligent automation solutions.
- Prepare business cases with ROI analysis and lead the implementation of automation platforms like RPA, OCR, and NLP to minimize manual work.
Your Profile
- Bachelor's degree, ideally in industrial engineering or business administration, economics, or a similar qualification.
- Good knowledge of Microsoft applications, particularly profound experience developing PowerPoint presentations, Excel sheet models, and MS Project.
- Problem-solving skills and leadership skills are essential.
- Willingness to travel.
- PMP certification.
- Business Analysis Certification.
- Six sigma green belt would be a plus.
- Insurance industry PM experience (4+ years).
- Proven delivery in integrations, regulatory/compliance (ADHICS, SOC 2, ISO), process improvements, and portal enhancements.
- Tools: Jira, Smartsheet, MS Project; advanced PowerPoint/Excel; fluent business English.
- Ability to partner with Risk/Compliance and Commercial; experience applying AI tools to PM deliverables.
- Good knowledge and experience in project management tools and methodologies, Business requirement documentation, and process re-engineering.
