Current jobs related to Clinical Investigator - Secunderabad, Telangana - unitedhealth group information services

  • Senior Clinical Research Associate

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeClinicalTrialCoordinator Full time ₹ 15,00,000 - ₹ 28,00,000

    Job DescriptionWe are seeking a Clinical Trial Coordinator to support our team in the planning, execution, and closing of early phase clinical trials. The ideal candidate will have experience with clinical study planning, execution, reporting, and publishing activities.The Clinical Trial Coordinator will work closely with the Lead Clinical Trial Leader,...

  • Healthcare Document Specialist

    1 week ago

    Hyderabad / Secunderabad, Telangana, India beBeeMedicalWriting Full time ₹ 1,04,000 - ₹ 1,30,878

    Medical Writer Position">Job Description:As a medical writer, you will be responsible for developing and reviewing clinical and regulatory documents essential for the advancement of medical research and product development. Your duties will include writing and reviewing various documents such as clinical trial protocols, clinical study reports, investigator...

  • Global Regulatory Writing Expert

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeRegulatory Full time ₹ 6,00,000 - ₹ 8,00,000

    Regulatory Writing Professional">Authored regulatory documents, including Clinical Study Reports, Investigator Brochures, and eCTD Module 2 Clinical Summary Documents.Conducted formal reviews and approvals of authored documents following standard operating procedures.Managed regulatory writing activities for product submissions, including new and...

  • Medical Operations Lead

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeClinical Full time ₹ 5,00,000 - ₹ 8,00,000

    Job Title: Clinical Operations Expert">At our organization, we seek a highly skilled and experienced Clinical Operations Expert to join our team. The ideal candidate will have extensive experience in pharmaceutical or biotech industries with strong clinical practice background.">The successful candidate will be responsible for providing medical support to...

  • Medical Supply Chain Coordinator

    1 week ago

    Hyderabad / Secunderabad, Telangana, India beBeeSupplyChain Full time ₹ 5,00,000 - ₹ 8,00,000

    Job Title: Supply Chain Coordinator - Medical ProductsAbout the RoleThe Supply Chain Coordinator - Medical Products will be responsible for developing and maintaining sustainable operational processes and relationships with Contract Manufacturing Organizations (CMOs) in outsourced medical supply chain activities.This includes setting up and leading...

  • Global Regulatory Operations Leader

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeRegulatory Full time ₹ 1,50,000 - ₹ 28,00,000

    Job Overview"," A Regulatory Manager is responsible for implementing global regulatory strategy and managing operational activities in assigned regions. Key performance indicators include successful implementation of regulatory strategy, identification of main HA issues, successful participation in HA interactions, and adherence to company policy and...

  • Healthcare Leader Position

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeChiefMedicalOfficer Full time ₹ 1,04,000 - ₹ 1,30,878

    Chief Medical Officer Job DescriptionAs a Chief Medical Officer, you will play a vital role in the healthcare industry. Your primary responsibility will be to oversee the medical services department and ensure that all patients receive high-quality care.Job ResponsibilitiesExamine patients and record their medical history in a safe, compassionate, and...

  • Advanced Pharmacovigilance Professional

    1 week ago

    Hyderabad / Secunderabad, Telangana, India beBeeICSRs Full time ₹ 15,00,000 - ₹ 28,00,000

    ICSRs Project ManagerOur team seeks a skilled and experienced ICSRs Project Manager to oversee the receipt and processing of adverse event reports from various sources. The successful candidate will maintain thorough understanding of client-specific database conventions and support reconciliation with internal or external partners as...

  • Global Regulatory Operations Manager

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeRegulatory Full time ₹ 1,04,000 - ₹ 13,08,780

    Job Summary\We are seeking a skilled professional to join our team as an Associate Global Program Regulatory Manager. The ideal candidate will have experience in implementing regulatory strategies and managing operational activities.\Main Accountabilities:\\Develop and implement global regulatory strategies for timely submissions and approvals.\Partner with...

  • **Multimodal Data Architectural Specialist**

    2 weeks ago

    Hyderabad / Secunderabad, Telangana, India beBeeDataStrategist Full time ₹ 7,00,000 - ₹ 12,00,000

    **Job Description:**">As a key member of our team, you will play a vital role in shaping the future of biomedical data management. The Semantic Technologies Lead will be responsible for establishing and implementing multimodal data roadmaps that contribute to identifying novel drug targets and therapeutic strategies.Interface seamlessly with semantic experts...

Clinical Investigator

2 weeks ago

Secunderabad, Telangana, India unitedhealth group information services Full time ₹ 5,00,000 - ₹ 10,00,000 per year

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Business Segment or Department

CPI Commercial Payment Integrity

Purpose of Job

This process works on identifying Fraud, Waste and Abuse between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve or deny claims and Identify provider aberrant behavior patterns. The associates prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with referring to client specific guidelines and member policies.

Fraud is intentionally misrepresenting or concealing facts to obtain something of value. The complete definition has three primary components:

  1. Intentional dishonest action or misrepresentation of fact
  2. Committed by a person or entity
  3. With knowledge that dishonest action or misrepresentation could result in an inappropriate gain or benefit

This definition applies to all persons and all entities. However, there are special rules around intentional misrepresentations to Government programs such as Medicare and Medicaid, or TRICARE.

Waste includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources.

Abuse includes any practice that results in the provision of services that:

  • Are not medically necessary
  • Do not meet professionally recognized standards for health care
  • Are not fairly priced
Primary Responsibilities
  • Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with referring to client specific guidelines and member policies
  • Adherence to state and federal compliance policies and contract compliance
  • Assist the prospective team with special projects and reporting
  • Coordinate with all team members and share recent process related updates
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so.
Required Qualifications
  • Medical degree MBBS or BHMS or BAMS or BUMS or BPT or MPT or BDS Graduate Results awaited candidates will not be accepted
  • Good knowledge on MS Word and MS Excel
  • Attention to detail and Quality focused
Preferred Qualifications
  • Knowledge of US Healthcare and coding
  • Proven high attention to detail which translates to 100 PERCENT quality of work performed
  • Proven readiness to support the business during peak volumes as & when needed
  • Proven good written and verbal communication skills
  • Proven team player
  • Proven good analytical skills. Ability to understand mistakes and correct them
  • Proven flexibility Ready to accommodate the working hours and working days depending on the Business Need
  • 100 PERCENT work from office
  • Demonstrated ability to work independently without close supervision

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission.

Apply Internal Employee Application Locations - Primary Location: Hyderabad, Telangana, IN

`घोटाले चेतावनी: JORA एक नौकरी खोज इंजन है । हम एक भर्ती नहीं कर रहे हैं और किसी भी भर्ती प्रक्रिया का हिस्सा नहीं हैं। हमारे कार्यालय केवल ऑस्ट्रेलिया में हैं। हम नौकरी चाहने वालों से कभी संपर्क नहीं करते या चयन उद्देश्यों के लिए उम्मीदवार से कभी संपर्क नहीं करते। यदि आपको कॉल या मेल प्राप्त होता है (बाहर की ) JORA से होने का दावा करने वाले व्यक्ति से आपको प्रासंगिक प्राधिकारियों से संपर्क करना चाहिए । उस व्यक्ति के बारे में आपकी सारी जानकारी के साथ । इसके अलावा, आपको साक्षात्कार चरण में संसाधित करने के लिए भुगतान करने की आवश्यकता नहीं होनी चाहिए। JORA उम्मीदवारों से कभी पैसे नहीं मांगते।

सावधान रहें और जागरूकindia ।
सादर,
JORA टीम ।