Clinical Healthcare BPO Consultant

Skills this role screens for

About the role

*For Pooling Purposes* • Provide consultancy services to the insurance and healthcare vertical to set up the clinical/bill review/insurance practice. • Establish and maintain communication with clients and/or team members; understand their needs, resolve issues, and meet their expectations. • Participate in RFPs, client proposals, client meetings & sales calls as directed by the supervisor. • Produce solid and effective strategies based on accurate and meaningful data reports and analysis and/or keen observations that would impact business outcomes. • Identify the training needs that will equip the staff with fundamental skills and knowledge for the clinical/bill review/insurance programs. • Have a thorough understanding of the various system tools and operational procedures utilized within the program and provide guidance/recommendations to the operations team on improving service delivery/outcomes. • Collaborate with stakeholders on a regular basis for creating strategies. • Conduct all defined and required process compliance and adherence to all team members, partners, and third-party providers for clinical insurance program and provide recommendations to improve the framework/rectify the identified gaps. • Earned a bachelor’s degree in any related field. • Registered Nurse (PH & US Licensed). • At least 15 years of work experience in the same industry with 2-3yrs of Director experience. • Proven experience in the healthcare/casualty/worker's compensation domain managing processes such as Intake, Clinical Utilization Review, Nurse Reviews, Medical Provider Call Center. • Excellent working knowledge on Microsoft Office applications. • Ability to efficiently manage time and keep track of multiple schedules, meetings, and initiatives. • Strong analytical skills. • Demonstrated leadership skills. All your information will be kept confidential according to EEO guidelines.