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The Electronic Platforms Project Manager is responsible for efficiently managing and overseeing electronic transitions and reforms, including regulatory projects related to medical provider management, with a focus on electronic post office systems across the GCC and extended MEA regions, as assigned. 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. The ideal candidate should have a strong understanding of medical coding systems, including but not limited to CPT, ICD (IM & CM), Australian coding (ACHI), DRG, E&M, and modifiers, along with experience in managing regulatory project E transitions. The position reports to MPM Manager/ Senior Manager of assigned region.
Job Responsibility:
Responsible for managing 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
Possesses comprehensive knowledge of local regulations related to e-platforms, and their implications, with responsibility for managing the E-transformation, pricing, and cost impact within the scope of Medical Provider Management (MPM)
Lead and manage regulatory projects related to medical provider management and electronic post office systems (such as DHPO, Shafafiya, Riayati, NPHEIS, Damani, etc.)
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
The incumbent must be capable of traveling across the GCC and extended regions as required for the assigned E-transformation projects
Support the implementation of objectives and drive the strategy set by the MPM
Work closely with internal teams (PMO, Operations, Claims Edits, Network Operations, Software Development, and Compliance) 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
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, including CPT, ICD, Australian coding (ACHI), DRG, E&M, and modifiers
Work/lead on projects (Global/Regional/Local Regulatory) as required for the business continuity in the region
Should be able to deliver on targets set locally, regionally and globally
Responsible for implementing the Local & Regional DOAP (Delegation of Authority Policy)
Provides weekly/monthly reports to the Manager and daily updates on priority matters
Adapt to the entire Allianz Partners Technical Infrastructure within all lines of businesses required to successful delivery of the assigned objectives/tasks
Guarantee Medical Provider Management business continuity, efficiency and service levels within the region
Other activities/ special projects as directed/ assigned by the MPM Senior Manager and Regional Head of MPM MEA from time to time
Requirements:
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
Proven experience in managing platform transitions and regulatory compliance
In-depth knowledge of electronic claims processes and medical coding systems
Deep understanding of the intricacies and requirements of local regulatory e-platforms
A thorough knowledge of local regulations, e-platforms, and their implications is essential
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
Physically fit to carry out duties
Logical thinking mind set and ability to solve problems
Strong communication (verbal & written), presentation and interpersonal skills
Fluent in written and verbal English and Arabic
other languages are an advantage
Analytical skills
Able to use a range of standard (Microsoft Office) and non-standard IT applications to support and enhance the work
Legally permitted to work in the country of operations
Flexibility and can work autonomously
Willingness and ability to travel internationally and stay in different countries as needed for project execution
Nice to have:
Fluent in written and verbal English and Arabic
other languages are an advantage
What we offer:
Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer
Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer
We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation
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