
Medical Officer
23 hours ago
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Blue Health is actively seeking a qualified and dedicated Medical Officer for Prior Authorization to join our healthcare team. The selected candidate will be responsible for conducting prior authorization reviews for medical procedures, treatments, and medications, ensuring clinical accuracy and adherence to established protocols. We are looking for professionals with strong medical expertise, effective communication skills, and the ability to thrive in a collaborative environment.
Key Responsibilities:- Evaluate prior authorization requests for medical necessity and appropriateness based on clinical guidelines.
- Review supporting clinical documentation to ensure accurate assessment of requested treatments or procedures.
- Coordinate and collaborate effectively within the internal medical team to streamline authorization decisions.
- Maintain thorough and accurate records of all prior authorization reviews and decisions.
- Provide clinical insights and support to team members as required.
- Stay updated with current clinical practices and healthcare standards relevant to prior authorization.
- Prior experience in prior authorization or clinical review is preferred.
- Excellent verbal and written communication skills in English.
- Ability to work effectively in a team-oriented and collaborative environment.
- Strong clinical judgment and attention to detail.
- MBBS/MD degree from a recognized institution (mandatory).
- Active and valid medical license (preferred).
- Minimum 2 years of clinical experience.
- Proficiency in using medical documentation tools and MS Office applications.
- Entry level
- Full-time
- Health Care Provider
- IT Services and IT Consulting
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