Medical Core System Transformation Lead I Dubai I Financial Services I Orient Insurance PJSC
- Dubai
- Permanent
- Full-time
- Lead the strategy, design, and execution of the medical core system transformation program.
- Act as the single point of accountability for business outcomes, timeline, and value realization.
- Translate enterprise strategy into a clear transformation roadmap (phased migration, MVPs, decommissioning).
- Own transformation across key medical domains, including:
- Claims adjudication and payment
- Policy & benefits configuration
- Provider and network management
- Authorizations and utilization management
- Medical pricing, rules, and payment logic
- Drive modernization from monolithic/legacy platforms to configurable, API-driven core solutions.
- Partner with Medical, Operations, Finance, Actuarial, Compliance, and Provider Relations teams.
- Ensure business rules, clinical workflows, and regulatory requirements are accurately digitized.
- Resolve trade-offs between standard product capability vs. local customization.
- Lead engagement with core system vendors, system integrators, and niche solution providers.
- Oversee solution design, deployment quality, and contractual commitments.
- Govern vendor delivery to ensure alignment with architecture, security, and compliance standards.
- Establish strong program governance, including milestones, dependencies, and risks.
- Manage multi-workstream delivery (technology, data, business readiness, migration, change).
- Ensure transformation is delivered with minimal disruption to ongoing business operations.
- Ensure core systems meet health insurance regulatory, payer, and data privacy requirements.
- Support audits, reporting, and compliance validation through system design and controls.
- Drive business adoption through process redesign, training, and change management.
- Define and track value realization metrics (speed, cost, accuracy, scalability).
- Enable future capabilities such as analytics, automation, and AI-driven operations.
- 12+ years of experience in health insurance, payer operations, or healthcare technology.
- Proven leadership of large-scale core system transformation programs in medical insurance.
- Deep understanding of medical claims, benefits, pricing, provider networks, and utilization management.
- Experience modernizing legacy medical core platforms to modern or SaaS-based solutions.
- Strong knowledge of health insurance core systems (claims/PAS/medical modules).
- Experience with system migration, data conversion, and parallel run strategies.
- Understanding of API-based integration, interoperability, and data architecture.
- Comfort working with enterprise architects, security, and data teams.
- Strong stakeholder management across business, clinical, technology, and vendors.
- Ability to lead through ambiguity and make pragmatic trade-offs.
- Executive-level communication and decision facilitation skills.
- Outcome-oriented mindset with strong delivery discipline.
- Core medical system migration delivered on time and within agreed scope.
- Reduction in claims processing time, errors, and manual interventions.
- Improved configurability of medical benefits and pricing.
- Measurable improvement in member and provider experience.
- Safe decommissioning of legacy platforms and technical debt reduction