- Coordinate and manage the medical network to ensure seamless case management and service delivery.
- Serve as the primary liaison between healthcare providers, patients, and internal teams to facilitate effective communication and resolution of medical cases.
- Monitor and evaluate the performance of network providers to ensure compliance with company standards and contractual obligations.
- Oversee the end-to-end process of medical case management, including case registration, assessment, authorization, and follow-up.
- Maintain accurate and up-to-date records of all medical cases and network activities in accordance with company policies.
- Analyze case data and generate regular reports to support decision-making and continuous improvement initiatives.
- Assist in the onboarding and credentialing of new healthcare providers into the medical network.
- Handle escalated cases and resolve complex issues by coordinating with relevant stakeholders.
- Support the development and implementation of network expansion strategies to enhance service coverage.
- Ensure adherence to regulatory requirements and best practices in medical case management.
Bachelor’s degree in Medicine or Pharmacy.2-4 years of experience in medical case management, healthcare coordination, or a similar role.Strong understanding of healthcare networks, insurance processes, and medical terminology.Excellent organizational and multitasking abilities to manage multiple cases simultaneously.Exceptional communication and interpersonal skills for effective stakeholder engagement.Proficiency in using healthcare management software and Microsoft Office Suite.Demonstrated ability to analyze data and prepare comprehensive reports.Attention to detail and commitment to maintaining high standards of accuracy.Ability to work independently and collaboratively within a fast-paced office environment.Familiarity with regulatory requirements and industry best practices in healthcare management.