Hassan Badawi Wagiaalla
Healthcare Risk Management Doctor
Riyadh
Summary
Insightful Manager with experience directing and improving operations through effective employee motivational strategies and strong policy enforcement. Proficient in best practices, market trends and regulatory requirements of industry operations. Talented leader with analytical approach to business planning and day-to-day problem-solving. Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Overview
10
10
years of professional experience
Work History
Manager Underwriting & Risk Management
Al Rajhi Company For Cooperative Insurance
06.2023 - Current
- Responsible for overseeing underwriting process and managing risk within organization. This role involves assessing insurance applications, determining level of risk associated with each applicant, and setting appropriate premiums or terms. Additionally, develops and implements strategies to mitigate risks, such as developing underwriting guidelines, analyzing data to identify trends, and collaborating with other departments to ensure compliance with regulatory requirements.
- Achieved departmental goals by developing and executing strategic plans and performance metrics.
- Reduced operational costs through comprehensive process improvement initiatives and resource management
Asst Manager Provider Relation & Reconciliation
Al Rajhi Company For Cooperative Insurance
09.2019 - 05.2023
- Excelled in fostering effective communication channels with healthcare providers, facilitating detailed analyses of claim rejections. Proficiently priced medical cases while meticulously assessing associated risks, thereby safeguarding company from adverse loss ratios.
- Demonstrated adeptness in establishing benchmarking methodologies for provider pricing, systematically comparing them with new provider price contracts across various parameters including region, type of healthcare provider, service availability, and cost. This meticulous approach ensured comprehensive evaluations, facilitating informed decision-making processes and optimizing cost-effectiveness for company.
Senior Specialist Pre-authorization
Bupa Arabia For Cooperative Insu Co
03.2018 - 09.2019
- Evaluate medical necessity and consistency of diagnosis,
procedure and drug codes and prescriptions stated on the
claim according to accepted medical coding rules and
guidelines while processing claims according to expected daily
target, quality and other key performance. - Conducted thorough market research to identify new business opportunities, leading to increased revenue streams
Senior Specialist Pre-authorization
MediVisa For Claims Settlement
11.2013 - 03.2018
- Review, analysis and abstracts health information, as well as
assigning diagnosis and procedure codes for health care
services utilizing International Classification of Diseases (ICD),
Current Procedure Terminology (CPT) & Healthcare Common
Procedure Coding (HCPCS) system.
Education
McKinsey Forward Program
Mckinsey & Company Global Management Consult
04.2024
High Diploma
The Royal College of Surgeons of Edinburgh
04.2021
I.F.C.E ( Insurance Foundation Certificate Exam )
The Financial Academy
06.2015
Registered As General Practitioner
The Saudi Commission For Health Specialties
08.2013
Full Registration As General Practitioner
The Sudanese Medical Council
04.2013
MBBS
Omdurman Islamic University
11.2011
Skills
Operations Management
Analytical Thinking
Excellent Communication
Business Analysis and Reporting
Team Development
Negotiation
Business Development
Team Leadership
Cost Control
Expectation setting
Problem-Solving
Customer Service
Timeline
Manager Underwriting & Risk Management
Al Rajhi Company For Cooperative Insurance
06.2023 - Current
Asst Manager Provider Relation & Reconciliation
Al Rajhi Company For Cooperative Insurance
09.2019 - 05.2023
Senior Specialist Pre-authorization
Bupa Arabia For Cooperative Insu Co
03.2018 - 09.2019
Senior Specialist Pre-authorization
MediVisa For Claims Settlement
11.2013 - 03.2018
McKinsey Forward Program
Mckinsey & Company Global Management Consult
High Diploma
The Royal College of Surgeons of Edinburgh
I.F.C.E ( Insurance Foundation Certificate Exam )
The Financial Academy
Registered As General Practitioner
The Saudi Commission For Health Specialties
Full Registration As General Practitioner
The Sudanese Medical Council
MBBS
Omdurman Islamic University