About the Job
Chedid Capital Group is a leading investment group in the (re)insurance industry with an extensive presence of 80-plus subsidiaries, powered by 1,700-plus employees across more than 85 countries in Europe, the Middle East, Africa, and Asia.
Through its diverse portfolio spanning (re)insurance, risk advisory, and education, the Group has built one of the industry's most dynamic networks, combining global scale and local market expertise.
Ascoma Insurance Advisor & Broker, a company of Chedid Capital Group, is looking for a Senior TPA Medical Operations & Digital Transformation Officer will be responsible for monitoring and improving the operational performance of the Group’s TPA Santé subsidiaries, overseeing the implementation of digital transformation initiatives, and ensuring the quality, efficiency, and standardization of medical insurance processes across the Group.
Responsibilities
- Monitor and assess operational processes across the full TPA Santé cycle, including policy administration, claims, pre-authorisations, billing, payments, provider management, and fraud prevention.
- Ensure compliance with Group procedures, internal control requirements, and Internal Audit recommendations.
- Monitor the quality and accuracy of operational transactions and data, identify discrepancies, and coordinate corrective actions with subsidiaries.
- Oversee the implementation of digital transformation projects across subsidiaries, identifying opportunities to improve productivity, service quality, operational efficiency, and cost control.
- Review and optimise existing processes, recommend process reengineering initiatives, and ensure the standardisation of operational practices across the Group.
- Monitor operational performance through KPIs, including productivity and quality control indicators.
- Coordinate with subsidiaries on project implementation, follow up on action plans, and lead operational governance meetings.
- Participate in system testing, monitor technical issues, and coordinate the deployment and stabilisation of new digital solutions.
- Contribute to the development of the Group's medical reference framework and the integration of AI solutions into healthcare processes.
- Support the implementation of Agile methodologies throughout the project lifecycle.
- Develop and deliver training to subsidiary employees and contribute to the preparation and updating of Group operational procedures and manuals.
- Support the implementation of mandatory health insurance schemes and complementary insurance processes.
Requirements
- Doctor of Medicine (MD), with clinical experience.
- Minimum 6 years of experience in health insurance, preferably in TPA operations.
- Experience in health insurance operations, digital transformation, and process improvement, with knowledge of healthcare systems and performance monitoring.
- Knowledge of ICD-10 and CPT coding systems is an advantage.
- Fluency in French and English, both written and spoken.
- Willingness to travel to African subsidiaries when required.
