Nurse Consultants

2 days ago

Ernakulam, India ADVENXA Full time
We AreLooking For Nurseconsultants

  • Industry:BPO(Healthcare)
  • JobTitle:NurseConsultant
  • Location:InfoparkKakkanadKochi
  • Exp:Minimum of 3years clinicalexperiencemandatory
  • Qualification: BSCNursing
  • Shift:Night Shift(6PM to 3AM (cab will beprovided))
  • Salary:35000/to 50000/ PerMonth
  • Shouldhave excellent fluency in English.
JobRole
  1. Providecomprehensive clinical review of complaints and appeals filed byproviders with the use of appropriate resources and guidelines toensure cost effective delivery of healthservices.
  2. Supportsidentification and review of appropriate case types in compliancewith the clinicalguidelines
  3. Promotes/supportsquality effectiveness of HealthcareServices.

FundamentalComponents & Physical Requirements (include but are notlimitedto)
  1. Reviewsdocumentation and evaluates potential quality of care issues basedon clinical policies and benefitdeterminations
  2. Considersall documented system information as well as any additionalrecords/data presented to develop a determination orrecommendation.
  3. Condensescomplex information into a clear and precise clinical picture whileworkingindependently.
  4. Datagathering requires navigation through multiple systemapplications.
  5. Utilizesclient systems to build research and enter memberinformation.
  6. Appliesclinical guidelines in determining clinicaldecisions
  7. Experiencein patient management in a clinical setting is a requirement tohelp with clinicalunderstanding
  8. Accuratelyapplies review requirements to assure case is reviewed by apractitioner with clinical expertise for the issue athand.
  9. Promotescommunication both internally and externally to enhanceeffectiveness of medical management services (e.g. ClaimAdministrators
  10. PlanSponsors and 3rd party payers as well as Member Family andHealthcare Team Membersrespectively)
  11. Protectsthe confidentiality of member information and adheres to companypoliciesregarding
  12. Abilityto understand and interpret clinical laboratory results andfamiliarity with clinical conditions and its management isrequired


Requirements
  • Qualification:BachelorofScienceinNursing
  • Experience:Min. of 3 year clinicalexp.
  • Shouldhave excellent fluency in English
  • willto work in shifts /Night Shift(6PM to3AM)


Benefits
  • Cab(pickup &Drop)
  • ESPF Healthinsurance
  • Basketofallowances


Education

BSCNursing

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