Quality & Operations Officer - Medical Insurance

métier – Strategic HR Solutions is hiring a Quality & Operations Officer – Medical Insurance for one of our clients in the UAE.We are looking for a medical insurance professional with strong experience in operations, quality assurance, process compliance and performance monitoring. The ideal candidate will have hands-on experience across medical insurance operations and a strong understanding of UAE health insurance requirements.Key ResponsibilitiesMonitor the quality and efficiency of medical insurance operational processes.Ensure compliance with policy terms, SLAs, SOPs and applicable regulatory requirements.Conduct operational audits, identify process gaps and support corrective actions.Monitor KPIs, turnaround times, complaints and overall service quality.Support process standardization and continuous improvement initiatives.Monitor operational performance and identify opportunities for improvement.Prepare regular management reports on operational performance and quality metrics.Support internal and regulatory audits and ensure required documentation is maintained.Coordinate with insurers, healthcare providers and internal departments to resolve operational issues.Ensure processes are consistently aligned with established policies and procedures.RequirementsBachelor’s degree in Healthcare Management, Insurance, Nursing, Medicine, Business Administration, or a related field.5–8 years of relevant experience in medical insurance operations, preferably within the UAE.Strong understanding of UAE health insurance processes and regulatory requirements.Experience across areas such as claims, pre-authorizations, provider networks, policy administration, customer service and quality assurance.Hands-on experience in SOP implementation, KPI monitoring, audits, process improvement and compliance.Strong analytical, reporting and problem-solving skills.Excellent attention to detail with the ability to identify process gaps and inconsistencies.Experience coordinating with insurers, healthcare providers and internal stakeholders.Professional certification in Healthcare Quality, Insurance, Claims Management or Risk Management will be an advantage.