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The Prior Approvals team is part of the Claims department within MetLife Egypt. This team is responsible for validating and authorizing medical service requests, ensuring compliance with policy terms and clinical guidelines before treatment is rendered. Their scope covers outpatient and inpatient services, including labs, radiology, maternity, and specialized procedures, while also managing anti-selection checks and cost control measures. By maintaining strict turnaround times and implementing robust controls, the team safeguards both customer satisfaction and operational efficiency.
Success in this role requires strong leadership and analytical decision-making skills, along with the ability to manage complex workflows under tight timelines. The Head of Prior Approvals is responsible for overseeing the end-to-end medical authorization process and driving operational excellence through compliance, cost control, and customer-centric service delivery.
- Lead the Prior Approvals team to ensure timely and accurate medical service authorizations aligned with MetLife’s standards and customer expectations.
- Create streamlined processes and innovative solutions that improve turnaround times and enhance member experience.
- Oversee compliance with clinical guidelines, policy terms, and cost-control measures across all approval workflows.
- Manage team performance, resource allocation, and operational KPIs to maintain efficiency and service excellence.
- Develop strategies for continuous improvement, leveraging data insights to optimize decision-making and reduce risk.
- Coordinate closely with claims operations, provider networks, and senior leadership to deliver integrated, customer-focused solutions
- Education: Bachelor’s degree in Medicine is a MUST.
- Experience: 10+ years of experience in Insurance is a must, 5 years minimum in healthcare claims management or medical authorization leadership roles.
- Skillset & Work Style: Exceptional leadership and team management skills, with a proactive approach to problem-solving and process optimization.
- Behavior & Attitude: Customer-centric mindset, strong ethical standards, and ability to thrive in a fast-paced, compliance-driven environment.
- Characteristic/Trait: Strategic thinker with excellent communication and stakeholder engagement capabilities.
- Strong leadership skills with a people-oriented approach, fostering collaboration and team engagement.
- Strategic vision for technology and career development, ensuring the team’s growth and alignment with organizational goals.
Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World’s 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
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