Director - Medical Summarization - Dr's with US Insurance Medical Director: Job Description Job Summary: Responsible for leading the team of medical professionals that currently supply medical summarization and insight services to stateside 3rd party casualty claims teams. This role would provide clinical and strategic oversight to a highly skilled group of medical professionals to ensure that skills are continually kept up to date, credentials are proper, and that organizational strategic objectives are met. Establish and have accountability for policies, procedures, controls, and operating structure to ensure that team output is in line with business goals while maintaining the highest level of medical professional compliance. This role would partner with stateside teams on the continually evolving strategic goals related to the medical services provided within the team. Key Responsibilities: - Lead a team of medical professional and specialists across varied medical backgrounds to provide clinical oversight and thought leadership - Build Medical Summarization and Insights COE - Responsible to manage Business processes focused on driving customer success and value-added outcomes - Recognize opportunities to optimize medical evaluation processes and identify developing trends - Drive and Implement people and business strategy across the DCIO - Lead projects and program execution of varied levels of complexity from a transition and transformation perspective - Demonstrate a sense of urgency and accountability for business issues - Identifying and resolving Customer and Business challenges in partnership with Stateside and organization's India teams - Manage complex processes and successfully enable a Continuous Improvement culture - Expand Capabilities of the team and continually focus on evolving nature of work/industry - Build and share Insights - Review work with leadership and partners to calibrate deliverables against expectations - Identify coaching/training needs for team from a business domain and skills perspective - Nurture employee engagement & retention, develop future managers - Manage operational risk and maintain business continuity plans - Build a strong cohesive partnership with Support and Enablement teams - Analyze business results to identify top opportunities and delver business outcomes Primary Skills: - Experience with handling Clinical processes / healthcare / Medical Claims Operations - Lead a span of 350+ members supporting Casualty medical processing - Drive business outcomes focused on achieving strategic goals and exposure to digital tools and solution - Experience with Case disease management which involved summarization of medical records - Exposure to workflows and Claims processing, with knowledge on billing and CPT/ICD coding, - Denials & negotiations/settlement processing would be preferred - Strong verbal/written communication skills; Able to communicate effectively at all levels - Strong technical vision and knowledge of industry trends; provide direction to enable the team and organization to make long term decisions and choices - Business acumen to translate complex technical views into business solutions and strategies - Demonstrated track record of executing and enabling changes across business operations Preferred Qualifications: Education and Experience - Medical Background in terms of Clinical experience and a Doctor of Medicine (Experience in Emergency/Casualty Departments, Ortho Experience) - Must have 20-24 years of Insurance experience with claims management experience, (and/or equivalent management experience in Healthcare & Casualty Services) - Managerial experience and/or demonstrated leadership experience influencing senior management/ stakeholder's experience. - Experience in working with GCC's would be preferred

Pune

Director - Medical Summarization - US Insurance 

Job Description for Director - Medical Summarization - US Insurance  in Watson Search Partner in  Pune for (20-28) years of experience. Apply Now!