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Clinical Review Specialist (RN)

Clinical Review Specialist (RN)

Infosys BPMMangaluru, Republic Of India, IN
7 days ago
Job description

Job description

Greetings from Infosys BPM Ltd.,

We are hiring for US Registered Nurse - clinical experience at Mangalore.

Please find below Job Description for your reference :

  • Job Location : Mangalore
  • Qualification : BSc / MSc nursing with NCLEX certification and active US RN license
  • Designation : Associate Consultant
  • Experience : 5+ Years
  • Shift : US Shift / Night shift
  • Employment Type : Full-Time.
  • Notice Period : Looking for Immediate Joining Or 15 Days

Job Description : 1.

  • Senior SME Skillset : Training, Data Management and reporting, Quality Tools, Descriptive Analysis, New 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

    If interested, please share your Updated Resume with below details to cs.elakiyadhevi@infosys.com

    Name :

    Email & Mobile Number :

    Graduation :

    Date Of Birth :

    Post-Graduation : (If applicable) :

    Total experience :

    Relevant experience :

    Current / Previous Company name :

    Current CTC :

    Expected CTC :

    Notice period :

    Current location :

    Thanks & Regards,

    Talent Acquisition Team

    Infosys BPM Ltd

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    Clinical Specialist • Mangaluru, Republic Of India, IN