Position - Associate Consultant ( Medical / Clinical review experience )

- Work Location : Mangalore
- Shift Timings : US Shift/ Night shift
- Notice Period : Immediately to 15 days
- Budget - 12 LPA

Requirement : BSc/MSc nursing with NCLEX certification and active US RN license (Desk side experience)

:

1. - 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.

- - Valuable 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

📌 Clinical Review Nurse – US Healthcare (Mangalore)
🏢 SELECTIONS HR SERVICES PRIVATE
📍 Mangalore