Overview
Compliance Officer – Medical Insurance Jobs in Abu Dhabi Emirate, United Arab Emirates at métier – Strategic HR Solutions
Title: Compliance Officer – Medical Insurance
Company: métier – Strategic HR Solutions
Location: Abu Dhabi Emirate, United Arab Emirates
Key Responsibilities
- Ensure end-to-end regulatory compliance across medical insurance operations including underwriting, pricing, claims, operations, IT, data privacy, and fraud management
- Monitor, interpret, and implement UAE health insurance regulations, circulars, and tariff rules across all departments
- Maintain compliance obligations register and track regulatory updates from CBUAE, DHA, DOH, and MOHAP
- Act as the primary liaison with regulatory authorities and manage inspections, audits, and regulatory submissions
- Oversee compliance audits, documentation, and maintain audit readiness across all functions
- Establish and manage compliance oversight for TPAs and third-party vendors including SLAs, KPIs, and audit rights
- Monitor and investigate Fraud, Waste & Abuse (FWA) cases in medical claims
- Ensure compliance with healthcare data privacy, confidentiality, and cross-border data regulations
- Review SOPs, policies, and internal procedures to ensure regulatory alignment
- Manage escalated complaints, regulatory disputes, and enforcement responses
- Support regulatory reporting, license renewals, and compliance reporting to senior management
Requirements
- Bachelor’s degree in Business, Law, Healthcare Management, or related field
- Minimum 5–10 years of experience in compliance within a health insurance company in the UAE
- Strong knowledge of UAE insurance and healthcare regulations (DHA, DOH, MOHAP, CBUAE)
- Experience in regulatory audits, compliance monitoring, and reporting
- Preferred certifications: ICA (International Compliance Association) or CFE (Certified Fraud Examiner)
- Experience in medical insurance operations including claims and –underwriting compliance
- Arabic language is preferred
