Senior Medical Specialist, Planner
4 days ago
We are looking for a highly skilled Clinical Lead, Development to join our team at Disruptive Doctors.
As a key member of our Disease Management programme, you will be responsible for providing strategic medical input and plan into the development of our key initiatives.
You will work closely with healthcare providers/specialists to capture more information and insights to provide effective care for patients.
Key Responsibilities:
- Evaluate and provide medical expertise/opinions on proposed treatments, procedures, drugs, and interventions for insurance claims management.
- Review and conduct research on relevant diseases/conditions and treatment plans by establishing sound medical standards for the purpose of health claims adjudication aligning with international recognized standards.
- Collaborate with healthcare providers/specialists to capture more information and insights to provide effective care for patients.
- Drive the development of a strong evidence base through structured collection, analysis, and interpretation of health data.
- Recommend preventative care measures to reduce the risk of illness or injury.
- Stay informed about advancements in medical practices and standards.
To be successful in this role, you will need:
- A valid APC.
- Ideal to have work experience in both government and private hospitals.
- Tertiary qualification in Medical Science (e.g., MBBS, MD) from an accredited institution.
- Work experience: At least 6-8 years of proven clinical experience. Active and unrestricted medical license, with board certification in relevant medical specialty.
- Other Requirements: Strong analytical skills with the ability to critically evaluate medical information. Familiarity with insurance claim processes and regulations is a plus. Proficient in using Microsoft Office. Have effective verbal and written communication skills.
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