Youssef Ahmed Elshaer

Pre-certification Officer | Licensed Pharmacist | Healthcare Data Analyst

Healthcare & TPA operations specialist with expertise in medical approvals and pre-certification across UAE (DHA/MOH), Oman, and Bahrain markets. Combining clinical pharmacy mastery with modern analytics tools (SQL, Python, Power BI, Advanced Excel) to optimize utilization workflows, accelerate turnaround time, and minimize claim rejection rates.

View Experience Download Resume Certifications Contact Me

+0 Years

Healthcare & Insurance Pre-certification Experience

0 Regional Markets

UAE (DHA/MOH), Oman, and Bahrain Coverage

+0 Core Data Tools

SQL, Python, Power BI & Advanced Excel

Professional Experience

Track record in medical pre-certification and clinical operations

Pre-certification Officer

Nextcare UAE / Allianz Partners

March 2024 - Present

Audited and evaluated pre-authorization claims across UAE, Bahrain, and Oman regional markets in compliance with DHA and regulatory guidelines.
Reduced claim rejections by rigorously detecting policy-benefit mismatches prior to service dispatch.
Collaborated closely with Medical Directors to optimize exception handling for Center of Excellence (CoE) cases.
Mentored and coached junior officers on coding best practices and policy frameworks to ensure high operational throughput.

Clinical Community Pharmacist

El Ezaby Pharmacies

Dec 2023 - March 2024

Administered precise prescription verification, chronic drug counseling, and adverse interaction profiling.
Ensured full compliance with Ministry of Health regulatory dispensing standards.

Pharmacist

El Bendary Pharmacies

Jan 2021 - July 2023

Provided patient-centric OTC consultations and managed pharmaceutical stock workflows.
Strengthened client retention and trust through consistent therapeutic education.

Core Competencies

Specialized capabilities combining medical judgment and data operations

Insurance & TPA Operations

Pre-Authorization Utilization Review Claims Optimization DHA / MOH Regulations Medical Coding Review

Data & Analytics

SQL Python (Pandas) Power BI Advanced Excel Operational KPIs

Clinical & Pharmacy

Pharmacology Drug Interaction Audit Patient Counseling Therapeutic Guidelines

Professional Skills

TAT Optimization Exception Handling Root Cause Analysis Cross-functional Comms

Education & Credentials

Academic qualifications and certified diplomas

Bachelor of Pharmacy

Tanta University

Graduated with Very Good Grade • 2017 – 2022

Data Analysis Professional Diploma

Egyptian Knowledge House

Hands-on coursework covering SQL database queries, Python analytics, Power BI dashboards, and advanced data modeling.

Let's Connect

Open for discussions regarding healthcare pre-certification, medical claims optimization, and health data opportunities.

elshairyoussef@gmail.com +20 114 678 9258 LinkedIn Profile