Doctor jobs in B N Road (Mysore) - Rive Bussiness Solutions Pvt. Ltd.

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  • Job View 8 Views
  • Applicants Less than 5 Applicants
  • 2020-10-14 2021-04-14

Job Description

Position: Doctor for Utilization Review

Remote Position: Work from Home at Night

Company: California Healthcare Company

Compensation: 20 Lacs per Year (Base 14 Lacs + Bonus 6 Lacs)

Job Description

Evaluate patients' clinical status using evidence-based criteria to determine medical necessity for detox, residential, PHP, and IOP authorizations.

Complete Initial, concurrent, Peer, and retrospective reviews in a timely manner to ensure continuous coverage.

Act as a liaison between managed care organizations and the facility's professional clinical staff.

Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and document all activities in a detailed manner in applicable CRM/EMR

Inform clinical and medical staff of any specific concerns that would extend or restrict patients' length of stay.

Facilitate peer review calls between facility and external organizations.

Perform concurrent reviews for patients to ensure that extended stays are medically justified and documented in the patient's medical records.

Act in coordination with the facility or corporate office's leadership team to improve the quality of services provided within the organization.

Initiate and complete the formal appeal process for denied admissions or continued stay.

Comply with Akua rules, policies and guidelines consistently

Maintain Facility Standards and inform supervisor of any deficiencies

Maintain professionalism in interactions with staff and insurance companies at all times and exercise maturity of judgment


Must be a Doctor/Dentist (M.D. preferred).

Must be able to work Night-time from Home for a California Healthcare company

Must speak Good English

Proficient in Excel, Word, and electronic charting

Ability to work with minimal supervision

Key Skills


Hospitals / Medical / Healthcare Equipments

Functional Area

Health Care / Pharmaceuticals / Medical

Number of Vacancy



Higher Secondary, Secondary School, Other Bachelor Degree, MD/Medicinae Doctor, M.B.A/PGDM, MS/Master of Surgery, M.Pharma, M.Sc, Other Doctorate Degree

About Rive Bussiness Solutions Pvt. Ltd.

Job Purpose:
To make telephonic calls and schedule appointments on lead data generated from various sources with an aim to increase the sales of the branch and positively contribute to achieve sales targets.
Job Responsibility:
Maximum number of appointments should be given
Outbound calling on data collected through lead generation activities/ secondary
data sources
Scheduling appointments for venue sales and direst sales out of these calls.
Being updated on new products and services.
Skill Required:
Applicant must enjoy working in a fast-paced environment and be able to thrive under pressure.
Should possess sound knowledge about the local market and local language.
Possess strong communication skills.
Have high closure orientation.
Strong Results Orientation and Execution Excellence
High Customer Centricity

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