Description
Provide medical advisory and recommendations to support healthcare claims management, medical cost control, provider management, and employee health and well-being in accordance with applicable medical standards and regulations. Responsibilities include reviewing healthcare claims and treatments, advising employees, evaluating healthcare providers, supporting medical audits and fraud identification, reviewing MCU results, supporting health promotion and HSSE initiatives, analyzing medical data, and ensuring compliance with medical standards, ethics, regulations, and confidentiality.
Requirements
Minimum Doctor of Medicine / Medical Doctor degree. Valid Medical Registration Certificate (STR). Minimum 1-3 years of experience as a Medical Doctor. Experience in health insurance, medical claims, medical audit, hospital, occupational health, or healthcare provider management is an advantage. Good understanding of medical review, clinical assessment, healthcare cost management, and occupational health. Strong analytical, communication, advisory, and report-writing skills. High integrity and commitment to medical confidentiality. Age 28-40. Education mapped from source: D4, S1, S2.
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