Job Description
The Manager of Coding Governance & Health Information will lead and develop the coding governance function at Bupa Arabia. This role is pivotal in setting strategic direction, ensuring regulatory compliance, and maintaining the integrity and effectiveness of clinical and business coding systems across the organization. The manager will serve as the principal authority on coding policies, systems, and practices, and will play a key leadership role in supporting the company’s clinical governance, claims and Preauthorization management, digital transformation, and data quality initiatives.
Ownership
- Lead the development and execution of the coding governance plan in alignment with Bupa Arabia’s broader clinical and digital strategy.
- Ensure strategic alignment of coding systems across business units.
- Provide oversight and leadership on complex coding issues and ensure continuous improvement.
Coding Systems Development
- Oversee the end-to-end development, implementation, and refinement of coding frameworks, including master coding lists, and coding manuals.
- Drive innovation in coding logic and rule development to enhance automation and consistency.
- Review and support all major updates and implementations.
Stakeholder Leadership
- Lead high-level coordination with key internal and external stakeholders (Claims, PA, IT, TQM, PR & Actuarial, IA, CCHI, SHC, NHIC, etc.)
- Act as the primary escalation point for all coding-related matters and system/policy changes.
- Establish strong partnerships with regulators and healthcare bodies.
Executive Reporting
- Provide strategic insights and reporting to senior leadership on coding initiatives, system performance, and project outcomes.
- Present regular analytics, KPIs, and forecasts.
- Ensure transparency and clarity across all levels.
Medical Team Capacity Building
- Lead organization-wide initiatives to build coding awareness and capability among Bupa Arabia’s medical teams.
- Oversee sessions, orientation for new joiners, workshops, and other learning mechanisms.
Risk & Compliance Management
- Champion a risk-managed culture within the coding unit.
- Ensure compliance with regulatory standards and proactively identify gaps in current systems.
- Lead initiatives to regularly review and enhance coding-related SOPs and frameworks.
Skills
- Claims Experience.
- Regulatory knowledge
- Healthcare insurance business.
- Computer skills.
- Data analysis.
- Medical background graduate.
- Coding qualification.