Mahmoud Mohamed El Shemy, Head Of Business Analysis

Mahmoud Mohamed El Shemy

Head Of Business Analysis

Assure Finance Technology - Dubai

Location
United Arab Emirates - Dubai
Education
Bachelor's degree, MS
Experience
17 years, 2 Months

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Work Experience

Total years of experience :17 years, 2 Months

Head Of Business Analysis at Assure Finance Technology - Dubai
  • United Arab Emirates - Dubai
  • My current job since August 2016

- Support the business in preparation of business cases for change initiatives.
- Support project pre-initiation activities such as request for proposal (RFP) reviews,
vendor selections, mergers and acquisition etc.
- Provides business analysis support to ensure that business requirements specifications
are documented according to standard templates using natural language.
- Interacts professionally with a diverse group of people, including but not limited to,
executives, managers, third party vendors, and subject matter experts.
- Managing the elicitation of approval for business requirements. Works closely with
delivery partners, developers and testers, both onshore and offshore, to answer questions
and clarify requirements when the need arises.
- Participates in technical design discussion, technical specifications review, creation of
functional specifications, and test strategies reviews to ensure that business requirements
are accurately reflected.

Control & processing Manager at GlobeMed Egypt
  • Egypt - Cairo
  • August 2012 to August 2016

- Managing the processing Dept. responsible for receiving and auditing and closing of service providers claims submitted to the company.
- managing the PBM division as a separate service provided by the company for pharmacy benefits.
- Setting plans for the company operations relevant to different functions and processes within different areas among the company.
- Managing the dispatching & reconciliation team responsible for dispatching closed claims to the insurance companies and follow up on the batches payments to be settled to the providers.
- Managing the Chronic Medications unit responsible for receiving chronic prescriptions addition requests from the clients, auditing them medically, processing them on the system to be dispensed directly from the pharmacy.
- Preparing and presenting company services demonstrations to the prospective clients and negotiating the insurance offers presented to the client to achieve the most suitable plan that fits his needs.

Claims Supervisor at MetLife Alico
  • Egypt - Cairo
  • March 2007 to July 2012

-managing claims auditors teams
- setting plans for completing claims audit within the agreed time frame.
- Auditing and closing of Expat claims incurred by foreign accounts fall under the coverage of the company.
- Meetings with internal and external clients
- negotiating and forsaking resolutions with health service providers contracted with the company.

Education

Bachelor's degree, MS
  • at كلية الصيدلة - جامعة عين شمس
  • June 2006

Specialties & Skills

Data Analysis
MS Project
Health Insurance
Project Management
MS Excel
MS office
Risk Management
Claims Management
Data Analysis
Jira Issue Tracking Tool
Tableu BI Tool
IBM Cognos Data Anlysis Tool

Languages

English
Expert
Spanish
Beginner

Memberships

Egyptian Pharmacy Syndicate
  • Member
  • June 2006

Training and Certifications

Associate Reinsurance Administration ARA (Certificate)
Date Attended:
May 2007
Valid Until:
May 2012
ALMI (Certificate)
Date Attended:
May 2007
Valid Until:
May 2012
ACS (Certificate)
Date Attended:
May 2007
Valid Until:
May 2012
FLMI (Certificate)
Date Attended:
May 2007
Valid Until:
May 2012