Live opening · Posted 8 hours ago
The key details from the original listing.
Description supplied by the original job listing.
Designation: Associate Consultant
Job Level: JL 4B
Work location: Mangalore (Work from Office)
Exp: 5-8 years
Notice Period: Immediate to 15 Days
Shift Timings: Night Shift(US Shift)
Qualification: BSc/MSc nursing with NCLEX certification and active US RN license (Desk side experience)
Job Description:
Senior SME Skillset: Training, Data Management and reporting, Quality Tools, Descriptive Analysis, New project Implementation.
Perform medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and Standard Operating procedures.
Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
Good understanding of US healthcare business
Knowledge of utilization management processes (preferred)
Ability to understand Milliman guidelines (preferred)
Knowledge of managed care, acute care, emergency room, cardiology, radiology, etc.
Understanding of ICD and CPT codes.
Technical Skill Set: Microsoft Word, Excel, Computer navigation, typing skills, effective communication skills, both verbal and written
Interested candidates please share your updated resume and below details to shazia.ahmad@infosys.com
Details:
Name:
Contact Number:
Email I'd:
DOB:
Total Years of Exp:
Relevant Years of Exp:
Current/ Previous Company Name:
Notice Period:
Current Location:
Preferred Location:
Current CTC:
Expected CTC:
Flexible for Night Shifts:
Graduation:
Post-Graduation (If applicable):
Work arrangement
No
Live timing from JobBeeper.
Recently tracked roles with full details and direct application links.