Location
Ernakulam (district) | India
Job description
We Are Looking For Nurse consultants
- Industry: BPO (Healthcare)
- Job Title: Nurse Consultant
- Location: Infopark KakkanadKochi
- Exp: min. of 18 months clinical experience mandatory
- Shift: Night Shift (6PM to 3AM)
- Salary: 30000/ to 40000/ Per Month
- Should have excellent fluency in English.
Job Role
- Provide comprehensive clinical review of complaints and appeals filed by providers with the use of appropriate resources and guidelines to ensure cost effective delivery of health services.
- Supports identification and review of appropriate case types in compliance with the clinical guidelines
- Promotes/supports quality effectiveness of Healthcare Services.
Fundamental Components & Physical Requirements (include but are not limited to)
- Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit determinations
- Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
- Condenses complex information into a clear and precise clinical picture while working independently.
- Data gathering requires navigation through multiple system applications.
- Utilizes client systems to build research and enter member information.
- Applies clinical guidelines in determining clinical decisions
- Experience in patient management in a clinical setting is a requirement to help with clinical understanding
- Accurately applies review requirements to assure case is reviewed by a practitioner with clinical expertise for the issue at hand.
- Promotes communication both internally and externally to enhance effectiveness of medical management services (e.g. Claim Administrators
- Plan Sponsors and 3rd party payers as well as Member Family and Healthcare Team Members respectively)
- Protects the confidentiality of member information and adheres to company policies regarding
- Ability to understand and interpret clinical laboratory results and familiarity with clinical conditions and its management is required
Requirements
- Qualification: Bachelor of Science in Nursing
- Experience: Min. of 18 months clinical exp.
- Should have excellent fluency in English
- will to work in shifts / Night Shift (6PM to 3AM)
Benefits
- Cab (pickup & Drop)
- ES PF Health insurance
- Basket of allowances
Excellent English
Job tags
Salary
