SME US Healthcar Clinical Review & Utilization Management, Mangalore

White Horse Manpower Consultancy; Mangaluru; On-site; INR 400,000 - 700,000; Full time

Benefits offered by this job

Incentives

Bonuses

Job summary

White Horse Manpower Consultancy in Mangaluru is seeking a clinical data analyst to conduct reviews and assess the medical necessity of healthcare services. You will handle UM and prior authorization clinical corrections and apply Milliman Care Guidelines (MCG) regulatory guidelines, while supporting SME activities, team training and quality management reporting.

Analysts will interpret ICD and CPT codes, analyse clinical data, support new project implementations, and collaborate with US

Responsibilities

• Analyse clinical data and support new project implementation.
• Work with US healthcare, managed care, acute care, ER, cardiology and radiology processes.
• Understand ICD and CPT codes; prepare reports

Job description

Conduct clinical reviews assess medical necessity of healthcare services

Handle UM, prior authorization clinical Correction

Apply Milliman Care Guidelines (MCG) regulatory guidelines

Support SME activities, team training, quality mgt reporting

Required Candidate profile

Analyse clinical data and support new project implementation.

Work with US healthcare, managed care, acute care, ER, cardiology and radiology processes.

Understand ICD and CPT codes; prepare reports

Perks and benefits

Plus incentives and Bonuses