Waleed Abd EL-Hamid Mahgoub

project managerment leadFull Time

• Job Details:• Lead work activities that significantly contribute to the Commercial Health LOB, including, but not limited to, Performance Management, Sales, Pricing, Underwriting, Finance, giving technical and market support, and liaising with Risk, Legal & Compliance. • Set goals and ambition for the product based on market needs and corporate / business plan objectives • Define a business plan and KPIs for the LOB • Communicate with all stakeholders to make sure goals are clear and vision is aligned with business objectives • Support all team members in their investigations and collaborate together to detect the health FWA with high accuracy. • Maintain full compliance of department to AXA standards and reactivity/contribution to all compliance processes • Participate in all departmental meetings and support new comers. • Plan, organize, execute investigations and data analysis to identify, evaluate and measure potential fraud and abuse to determine valid cases for appropriate action • Utilize data mining and visualization programs to design queries and analyze claims data to detect outliers or suspicious patterns for further investigation • Follow-up with network & client relation team for any reported case. • Follow up for any new initiative or project related to medications dispensing (ex-chronic posting initiative). • Provide training on FWA to different teams if needed. • Support on a regular audit on the paid claims and the issued approvals.