Compliance Officer - Medical Insurance

Key ResponsibilitiesEnsure end-to-end regulatory compliance across medical insurance operations including underwriting, pricing, claims, operations, IT, data privacy, and fraud managementMonitor, interpret, and implement UAE health insurance regulations, circulars, and tariff rules across all departmentsMaintain compliance obligations register and track regulatory updates from CBUAE, DHA, DOH, and MOHAPAct as the primary liaison with regulatory authorities and manage inspections, audits, and regulatory submissionsOversee compliance audits, documentation, and maintain audit readiness across all functionsEstablish and manage compliance oversight for TPAs and third-party vendors including SLAs, KPIs, and audit rightsMonitor and investigate Fraud, Waste & Abuse (FWA) cases in medical claimsEnsure compliance with healthcare data privacy, confidentiality, and cross-border data regulationsReview SOPs, policies, and internal procedures to ensure regulatory alignmentManage escalated complaints, regulatory disputes, and enforcement responsesSupport regulatory reporting, license renewals, and compliance reporting to senior managementRequirementsBachelor’s degree in Business, Law, Healthcare Management, or related fieldMinimum 5–10 years of experience in compliance within a health insurance company in the UAEStrong knowledge of UAE insurance and healthcare regulations (DHA, DOH, MOHAP, CBUAE)Experience in regulatory audits, compliance monitoring, and reportingPreferred certifications: ICA (International Compliance Association) or CFE (Certified Fraud Examiner)Experience in medical insurance operations including claims and --underwriting complianceArabic language is preferred