Job Description
Description and Requirements
The Team You Will Join
The Prior Approvals team is part of the Claims department within MetLife Egypt. This team is responsible for validating and authorizing medical service requests, ensuring compliance with policy terms and clinical guidelines before treatment is rendered. Their scope covers outpatient and inpatient services, including labs, radiology, maternity, and specialized procedures, while also managing anti-selection checks and cost control measures. By maintaining strict turnaround times and implementing robust controls, the team safeguards both customer satisfaction and operational efficiency.
The Opportunity
The Head of prior approvals is responsible for leading the team that validates and authorizes medical service requests, ensuring compliance with MetLife’s clinical and policy standards. This position is critical to maintaining operational efficiency, cost control, and customer satisfaction by preventing misuse and managing turnaround times for approvals. Based in Egypt, the role supports the broader Claims function and contributes directly to MetLife’s purpose of delivering trusted, high-quality healthcare solutions to members. This is an exciting opportunity to shape the customer experience by driving process improvements, leveraging data insights, and collaborating with cross-functional teams to enhance service delivery. The successful candidate will lead initiatives that reduce delays, optimize workflows, and implement innovative solutions in a fast-paced environment, making a tangible impact on both business performance and member well-being.
Success in this role requires strong leadership and analytical decision-making skills, along with the ability to manage complex workflows under tight timelines. The Head of Prior Approvals is responsible for overseeing the end-to-end medical authorization process and driving operational excellence through compliance, cost control, and customer-centric service delivery.
You’ll collaborate closely with claims operations, provider network teams, business team and senior management, in an environment where every contribution is respected and every perspective is heard. This role offers the chance to influence strategic initiatives and improve healthcare outcomes for thousands of members.
How You’ll Help Us Build a Confident Future (Key Responsibilities)
- Lead the Prior Approvals team to ensure timely and accurate medical service authorizations aligned with MetLife’s standards and customer expectations.
- Create streamlined processes and innovative solutions that improve turnaround times and enhance member experience.
- Oversee compliance with clinical guidelines, policy terms, and cost-control measures across all approval workflows.
- Manage team performance, resource allocation, and operational KPIs to maintain efficiency and service excellence.
- Develop strategies for continuous improvement, leveraging data insights to optimize decision-making and reduce risk.
- Coordinate closely with claims operations, provider networks, and senior leadership to deliver integrated, customer-focused solutions
What You Need To Succeed (Required Qualifications)
- Education: Bachelor’s degree in Medicine is a MUST.
- Experience: 10+ years of experience in Insurance is a must, 5 years minimum in healthcare claims management or medical authorization leadership roles.
- Skillset & Work Style: Exceptional leadership and team management skills, with a proactive approach to problem-solving and process optimization.
- Behavior & Attitude: Customer-centric mindset, strong ethical standards, and ability to thrive in a fast-paced, compliance-driven environment.
- Characteristic/Trait: Strategic thinker with excellent communication and stakeholder engagement capabilities.
What Can Give You An Edge (Additional Skills)
- Strong leadership skills with a people-oriented approach, fostering collaboration and team engagement.
- Strategic vision for technology and career development, ensuring the team’s growth and alignment with organizational goals.
About MetLife
Recognized on Fortune magazine’s list of the “World’s Most Admired Companies” and Fortune World’s 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple – to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values – Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead – we’re inspired to transform the next century in financial services. At MetLife, it’s #AllTogetherPossible . Join us!
