Years of professional experience in Healthcare
Abdelaleem Shishi
Chief Revenue Officer
Overview
17
17
20
20
years of post-secondary education
Professional summary
Transformational healthcare executive with over 17 years leading operational turnarounds and revenue optimization across Middle East healthcare organizations. Proven track record architecting comprehensive revenue cycle transformations that drive profitability, operational excellence, and sustainable growth. Strategic leader with unique blend of clinical foundation, business acumen, and digital innovation expertise.
Leadership Philosophy: Building high-performing teams, implementing data-driven strategies, and creating scalable operational frameworks that deliver measurable organizational impact while maintaining focus on patient care excellence and regulatory compliance.
Work history
Group Chief RCM and Sales Officer
Saudi German Health Group
, Saudi Arabia
Apr 2019 - Current
- Lead comprehensive revenue cycle transformation and sales operations across 10 facilities (8 hospitals and 2 polyclinics) managing operations for one of Saudi Arabia's prominent private healthcare networks.
- Lead and direct development and delivery of Sales & RCM strategy and manage all aspects sales, revenue cycle, claims and client relationships in SGH group.
- Direct 300+ RCM and Sales professionals responsible for SAR 3+ billion in annual managed revenue.
- Budget monitoring & forecast for sales & Insurance, Supervising Revenue Cycle Department in various duties, such as account management, communications with insurance providers, collections, cash posting, contract analysis, and billing, Increased performance of all related activities to ensure sales and cost optimizations to contribute overall success of SGH Group.
- Leading diverse team of RCM and sales professionals, providing ongoing training and development to ensure staff is at forefront of industry standards and practices.
- Analyze industry and competitor trends to enhance sales strategy.
- Developed integrated sales and RCM strategy creating seamless customer journey from acquisition through payment collection
- Expanded payer network from existing base to 15+ major insurance companies through strategic relationship development
- Led business development initiatives capturing new opportunities across corporate, government, and insurance sectors
- Implemented B2B customer acquisition programs targeting corporate accounts, medical tourism, and Hajj / Umrah segments
- Created data-driven revenue optimization framework analyzing demographics, utilization patterns, and reimbursement trends
- Built high-performing, scalable teams and RCM Academy (500+ professionals), strengthening culture, KPIs, and cross-functional collaboration.
- Built high-performing sales organization with consultative selling capabilities and value-based approach
KSA Regional Business Development Manager for Insurance & Sales
Andalusia Group for Medical Services
2015.08 - 2019.02
Led regional business development, sales operations, and insurance management for major Saudi healthcare provider. Drove revenue growth through strategic payer partnerships, market expansion initiatives, and sales team development. Managed comprehensive insurance department operations and revenue cycle functions across multiple facilities.
Key Responsibilities & Achievements:
- Business Development & Sales: Developed and executed regional sales strategy targeting corporate accounts, insurance networks, and individual segments. Identified new market opportunities and established strategic partnerships expanding organizational revenue base and market presence
- Payer Relations & Network Expansion: Established and maintained relationships with major insurance companies and Third-Party Administrators. Negotiated contracts and service agreements improving reimbursement terms and expanding covered services portfolio
- Revenue Optimization: Directed comprehensive insurance operations including account management, payer communications, collections, and contract analysis. Implemented revenue maximization strategies optimizing payer mix and service line profitability
- Performance Management: Monitored AR balances, rejection rates, and revenue collection performance across facilities. Prepared detailed billing and accounts receivable analyses for executive leadership driving data-driven decision making
- Team Development: Led staff development ensuring adherence to industry standards and contractual requirements. Built sales and RCM capabilities through training programs and performance coaching
- Market Intelligence: Analyzed competitor strategies, pricing models, and market trends informing business development priorities and competitive positioning
Head of Insurance Department
Al Adwani General Hospital
Taif
2008.06 - 2015.05
Managed all insurance operations and clinical coding functions for regional hospital. Established foundational RCM expertise including medical coding (ICD-10-AM), medical review processes, and payer relationship management. Served as hospital representative across multiple insurance companies.
Key Responsibilities:
- Headed Clinical Coding Department implementing ICD-10-AM standards.
- Served as Medical Reviewer and Aramco MD Liaison ensuring documentation quality.
- Led Patient Affairs Department managing patient experience and complaint resolution.
- Ensured accurate claim submission and timely collections per third-party contracts.
- Monitored key performance metrics including rejection rates, AR days, and bad debt expense.
Education
Bachelor of Medicine & General Surgery (M.B.B.S.) -
Al-Azhar University
Sept 1998 - Feb 2005
Master of Business Administration - Marketing Specialization
Arab Academy For Science, Technology And Maritime
Egypt June 2022 - Jul 2024
Enter your degree - Chief Revenue Officer Executive Education Program
University of Chicago
USA Mar 2024 - Dec 2024
Insurance Foundation Certificate Exam (IFCE) -
Institute of Banking (IOB), Saudi Arabian Monetary Agency (SAMA)
Sept 2013 - Sept 2013
ICD ACS10AM, ACHI and 6th Edition Clinical Coding Course Information -
Health Information Management Association of Australia Ltd (HIMAA)
Aug 2013 - Sept 2014
The Revenue Cycle Management (RCM) Training Course. -
CCHI & Prince Noura University
2021.02 - 2021.02
Skills
- Complex negotiating
- Cost benefit analysis
- Customer acquisition
- B2B sales techniques
- Data analysis
- Staff Training & Coaching
Governance Experience
- Regular C-suite and board reporting on financial performance, strategic initiatives, and risk management
- Multi-stakeholder management across government payers, private insurers, regulatory bodies, and clinical leadership
- Strategic planning development and execution with measurable outcomes
- Regulatory compliance oversight with proven excellence track record
BOARD & ADVISORY QUALIFICATIONS
Committee Expertise:
Strategy & Growth Committee
Strategic planning and execution leadership. Competitive positioning expertise enabling market-leading performance. Organizational transformation experience driving measurable results.
Technology & Digital Transformation Committee
Digital transformation leadership including AI/ML deployment, HIS implementation, and RCM automation strategy. Experience developing and deploying innovative technology solutions addressing operational challenges.
Quality, Costing & Revenue (QCR) Committee
Integrated quality-finance leadership linking clinical excellence with revenue integrity and cost optimization. Expertise in claims accuracy, coding quality standards, denial prevention, and quality-driven reimbursement maximization. Experience aligning clinical documentation improvement with revenue cycle performance and cost containment initiatives.
Audit Committee
Financial oversight capabilities with demonstrated P&L impact and accountability. Extensive experience in regulatory compliance maintaining exceptional adherence rates across multiple frameworks. Risk management expertise including dispute resolution and penalty mitigation.
Risk & Compliance Committee
Enterprise risk management across multi-facility healthcare operations. Proven track record managing contractual risk, regulatory compliance (MOH, CHI, GOSI), and operational risk identification and control.
Finance Committee
Strategic financial planning and execution experience. Revenue optimization, cash flow management, and working capital optimization expertise. Capital allocation evaluation supporting strategic growth initiatives.
AREAS OF EXPERTISE
Organizational Transformation
• Healthcare turnaround strategies • Change management • Process reengineering • Performance improvement • Scalable operating models
Sales & Business Development
• Strategic sales planning • Market expansion strategies • B2B healthcare sales • Customer acquisition & retention • Value-based selling • Corporate account management • Consultative selling • Sales team leadership
Revenue Maximization & Optimization
• Revenue cycle management • Pricing strategy development • Payer mix optimization • Service line profitability • Dynamic pricing models • Revenue intelligence & analytics • Contract negotiation & optimization
Revenue Cycle Management
• Claims optimization • Denial management • Coding excellence • AR management • Cash flow optimization • Payer relations • Financial forecasting
Digital & Technology
• AI/ML implementation • Automation solutions • HIS integration • Analytics platforms • Predictive modeling • Data governance • CRM systems
Strategic Leadership• Vision 2030 alignment • Healthcare market dynamics • Competitive positioning • Stakeholder management • Team development • Market intelligence
TECHNICAL PROFICIENCIES
RCM Systems: NPHIES Platform | DRG Billing Systems | HIS Integration | Claims Management Systems | Revenue Management Platforms
Analytics & BI: Power BI | Tableau | Advanced Excel | SQL | Predictive Analytics | Real-Time Dashboards | KPI Monitoring
AI & Automation: AI RCM Solution | Machine Learning Models | Automated Coding Validation | Denial Prediction Systems | Workflow Automation
Healthcare Standards: ICD-10-AM | ACHI | DRG Methodologies | MOH Standards | CBHI Regulations | GOSI Requirements | Clinical Documentation
Languages: Arabic (Native) | English (Fluent – Business & Technical)
CAREER HIGHLIGHTS SUMMARY
Transformational Leadership
Led comprehensive revenue cycle transformation and sales operations across 10-facility healthcare network, architecting end-to-end operational excellence program that delivered exceptional organizational financial performance and positioned organization as industry leader.
Revenue Growth & Business Development
Spearheaded integrated sales and RCM strategy driving revenue maximization through market expansion, payer network development, and customer acquisition initiatives. Developed data-driven approach to revenue optimization combining pricing strategy, service line management, and customer intelligence.
Digital Innovation Pioneer
Spearheaded RCM digital transformation initiative deploying AI-powered solutions, predictive analytics platforms, and custom automation tools. Developed in-house innovation capabilities creating sustainable competitive advantage.
Team Builder & Talent Developer
Built high-performing team of 300+ sales and RCM professionals and established RCM Academy training 500+ healthcare finance specialists. Created culture of excellence, accountability, and continuous improvement across distributed operations.
Strategic Payer Relations
Managed complex relationships with 15+ major insurance companies and government payers including MOH, securing favorable contracts and achieving industry-leading approval rates including prestigious Hajj operations contract.
Operational Excellence Champion
Transformed key performance metrics achieving industry-leading standards in claims acceptance, AR management, denial rates, and coding accuracy. Delivered substantial cost reductions while improving service quality.
Vision 2030 Contributor
Positioned organization to support Saudi Arabia's healthcare transformation goals, optimizing operations for Western Region pilgrimage healthcare needs and enabling capacity expansion aligned with national objectives.
PROFESSIONAL REFERENCES
Available upon request, including:
- C-Suite Healthcare Executives
- Board Members of Healthcare Organizations
- Senior Insurance Company Leaders
- Healthcare Industry Consultants and Peers
- Professional Regulatory Contacts