Manager - COE Claims & Pre-Authorization

This role is responsible for leading and overseeing Pre-Authorization (PA) MENA and COE Claims Operations, ensuring timely, compliant, and high-quality service delivery across pre-authorization and claims functions. The role is accountable for SLA performance, operational governance, regulatory and SOP compliance, quality management, escalation resolution, audit readiness, stakeholder engagement, people development, and continuous improvement to support member, provider, client, and business expectations.

RESPONSIBILITIES AND DUTIES

Service Delivery, SLA Management & Operational Control

Oversee daily PA MENA and Claims Operations to ensure timely work allocation, queue management, backlog control, and delivery against agreed service standards.

Governance, Compliance, Quality & Audit Readiness

• Monitor daily inventory, aging cases, pending queues, high-risk cases, and backlog trends, with escalation of material SLA risks within th...