SME US Healthcar Clinical Review & Utilization Management, Mangalore
White Horse Manpower · Not specified · onsite · Posted 2d ago
₹8.0L - ₹12.0L PA5–9 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
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
Work with US healthcare, managed care, acute care, ER, cardiology and radiology processes.
Understand ICD and CPT codes; prepare reports
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 BonusesSourced from naukri
Skills
Milliman Care GuidelinesMedical NecessityPrior AuthorizationUS HealthcareClinical Reviewutilization managementMCGManaged Care
About White Horse Manpower
White Horse Manpower
25
employees
2007
19 years old
Bangalore / Bengaluru, Karnataka
India
₹3.1L PA avg
Avg at White Horse Manpower
₹8L – ₹12L PA
This role
About
Recruitment and staffing company for IT and no IT
Industries
ConsultingHuman ResourcesOutsourcingRecruitingStaffing Agency
Employee ratings
10 reviews
4.1/ 5
Culture
4.1
Career growth
4.0
Work-life
3.9
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