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:

1. Senior SME Skillset: Training, Data Management and reporting, Quality Tools, Descriptive Analysis, Current project Implementation.
2. Perform medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and Standard Operating procedures.
3. Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
4. Good understanding of US healthcare business
5. Knowledge of utilization management processes (preferred)
6.



Ability to understand Milliman guidelines (preferred)
7. Knowledge of managed care, acute care, emergency room, cardiology, radiology, etc.
8. 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 [email protected]
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Flexible for Night Shifts:
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📌 Hiring For US Registered Nurse (NCLEX & US RN License) - Mangalore
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📍 Mangalore