Job description

The Medical Core System Transformation Lead – Health Insurance Technology role at Orient Insurance PJSC, part of Al-Futtaim Group, is responsible for end-to-end delivery of the health insurer’s core medical system modernization, including policy administration, claims, benefits, provider management, and clinical integrations. The role leads business-led transformation of legacy medical systems into a modern, scalable, compliant, and digital-first platform that supports operational efficiency, improved member and provider experience, regulatory compliance, and future analytics, automation, and AI-driven capabilities. The position includes leading strategy, design, and execution of transformation programs, managing phased migration strategies, MVP rollout, and safe decommissioning of legacy platforms. The role owns transformation across medical domains including claims adjudication and payment, policy and benefits configuration, provider and network management, authorizations, utilization management, medical pricing, payment logic, and rules configuration. The position collaborates with Medical, Operations, Finance, Actuarial, Compliance, and Provider Relations teams to digitize business rules, clinical workflows, and regulatory requirements. The role leads vendor engagement including system integrators and solution providers, governs architecture, security, and compliance standards, and ensures program governance across multiple workstreams including technology, data, migration, business readiness, and change management. The Medical Core System Transformation Lead ensures compliance with healthcare regulatory frameworks, payer requirements, and data privacy standards, while driving adoption through process redesign, training, and value realization tracking. The role requires expertise in health insurance core systems, claims modules, PAS, system migration, API-based integration, interoperability, data architecture, SaaS modernization, and enterprise transformation delivery.