Dr. MONA ALSAHLY

Dedicated and results-driven medical consultant with a strong background in revenue cycle
management (RCM) and healthcare policy transformation, health insurance operations. Seeking
to contribute to national health system through the analysis, development, and implementation
of health standards to improve healthcare outcomes and strategic planning.
Proven ability to bridge clinical knowledge, insurance frameworks (CCHI), and data-driven
decision making to improve organizational outcomes. Skilled in population health management
and process optimization. Passionate about advancing digital health, healthcare consulting, and
transformation projects that support Vision 2030

• Directed medical insurance operations (approvals, claims, rejections) ensuring
compliance with CCHI regulations.
• Improved revenue cycle efficiency by redesigning workflows, reducing claim denials, and
accelerating approvals.
• Collaborated with insurers and CCHI as a consulting partner to resolve systemic
challenges, ensuring alignment with national insurance standards.
• Implemented policies that enhanced financial efficiency and operational sustainability.
• Developed preventive health insurance models integrating PHM and value-based
healthcare.
• Enhanced data-driven oversight by aligning with KPIs.
• Ensured adherence to regulations, in accordance to the Insurance Authority and
Cooperative Health Insurance Council
• Collaborated in cross-functional teams to standardize procedures, improve claim review
workflows, and enhance integration with digital health and e-claim systems
• Communicated with medical insurance companies, the Insurance Authority, Council of
Cooperative
Health Insurance (CCHI), to resolve challenges related to insurance operations
• Analyzed periodic reports on insurance approvals, rejections, and coordination activities,
enabling data informed decisions and performance evaluation
• Participated in the development of short-term and long-term plans with management
• Monitored KPIs related to approvals, turnaround times, rejection causes, and provider
compliance, helping to inform policy refinement and operational decisions
• Supervised compliance with approved quality standards that fall under the unit's
responsibilities.
• Monitored resources and manpower, ensuring the smooth execution of insurance￾
related activities and service delivery
• Responded quickly to meet customer needs and resolve problems.
• Participated in ongoing training to enhance own job skills and knowledge.
• Participated in national public health initiatives, including programs with the WHO and
Ministry of Health—supporting national health priorities
• Contributed to national and regional awareness campaigns, including Global Health Days
and GCC health weeks, enhancing public engagement and education

• Insurance Foundations Professional Certificate of Exam (IFCE), 2019, The Financial Academy (Saudi Central Bank), KSA
• Medical Insurance Certificate, Bahrain Institute of Banking and Finance (BIBF)
• Claims of the Cooperative Health Insurance Certificate, The Financial Academy (Saudi Central Bank), KSA
• Insurance Risk Management Certificate, The Financial Academy (Saudi Central Bank), KSA
• International Standard for Insurance Contracts IFRS-17 Certificate, The Financial Academy (Saudi Central Bank), KSA
• Fraud in Insurance Certificate, The Financial Academy (Saudi Arabian Monetary Authority), KSA
• Coding & Revenue Cycle Workshops Certificate, UMM ALQURA University
• Medical Insurance Training, Accumed Company
• Project Management Professional (PMP) Certificate

• Saudi Commission for Health Specialties, Member of Evaluation Committee for Dental Public Health Dentists
• King Saud University, Member of the Advisory Board - College of Applied Medical Sciences, 2019
• Saudi Commission for Health Specialties, Membership

Arabic: Native English : Fluent