Health Insurance Finance & Localization in Public Sector

Introduction

In light of the rapid developments in the healthcare sector, and the increasing pressure faced by the public health sector to deliver high-quality services, it has become essential to develop efficient systems for managing financial accounts related to health insurance.

This course aims to empower financial and administrative professionals with the latest skills and practices in managing financial operations tied to health insurance services. It emphasizes the concepts of localization (Saudization/Nationalization) and the development of national capabilities in this critical field, ensuring financial sustainability and enhancing the quality of services delivered to beneficiaries.

Course Objectives

By the end of this course, participants will be able to:

• Understand the general framework of health insurance in the government sector.
• Professionally and systematically manage financial accounts related to health insurance.
• Develop an integrated financial system that links medical services with budgets and claims.
• Apply localization principles in financial account management efficiently.
• Prepare accurate financial reports that support better decision-making in healthcare institutions.

Course Topics

Day 1: Basic Concepts of Health Insurance and Public Health Financing

• Introduction to health insurance systems.
• Differences between public and private insurance.
• Healthcare financing models.
• The role of the public sector in delivering and insuring health services.

Day 2: Medical Cost Analysis and Linking to Financial Accounts

• Classification and documentation of medical services.
• Analysis of health service costs.
• Billing management and insurance claims.
• Techniques for monitoring and analyzing medical spending.

Day 3: Localization of Financial Management in Health Insurance

• Concepts of localization in financial management.
• Strategies to build national competencies in health accounting.
• Automation of financial systems and use of modern software.
• Case studies and successful real-life models.

Day 4: Claims Management and Financial Auditing in Health Insurance

• The cycle of insurance claims (from service provision to reimbursement).
• Policies and procedures for financial review.
• Financial and technical auditing of claims.
• Common challenges and solutions in claims management.

Day 5: Financial Reporting and Decision-Making

• Types of financial reports in the health insurance sector.
• Key performance indicators (KPIs) – both financial and operational.
• Utilizing reports to enhance performance and support decision-making.
• Final workshop: Design an integrated model for managing health insurance accounts in a healthcare institution.

Why Attend This Course: Wins & Losses!

• Ability to effectively manage financial resources related to health insurance.
• Advanced skills in cost analysis and budget planning for health services.
• Mastery in producing accurate financial reports that drive decisions.
• Deep understanding of financial localization strategies and national capacity building.
• Practical exposure through real-world case studies and hands-on workshops.

Conclusion

This course represents a pivotal step for professionals aiming to excel in managing financial accounts related to health insurance within the public health sector.

By integrating theoretical knowledge with practical application — through a focus on financial analysis, planning, automation, and localization — participants will be fully equipped to meet today’s challenges and shape a more sustainable and efficient future in healthcare finance.