SME US Healthcare Clinical Review & Utilization Mgt NCLEX/USRN Qualifi (Mangalore)

SME US Healthcare Clinical Review & Utilization Mgt NCLEX/USRN Qualifi (Mangalore)

26 Oct
|
White Horse Manpower Consultancy Private
|
Mangalore

26 Oct

White Horse Manpower Consultancy Private

Mangalore

Conduct medical necessity clinical reviews of healthcare authorization requests in accordance with regulatory requirements, established guidelines, SOPs

Assess the clinical appropriateness of requested healthcare services using clinical knowledge

Required Candidate profile

Apply Utilization Mgt (UM) processes Milliman Care Guidelines (MCG) in clinical reviews

Support training, knowledge sharing, quality mgt, SME-level

Understanding of US healthcare ops managed care

Perks and perks

Plus Incentives and Bonuses

📌 SME US Healthcare Clinical Review & Utilization Mgt NCLEX/USRN Qualifi (Mangalore)
🏢 White Horse Manpower Consultancy Private
📍 Mangalore

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