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Clinical Lead (199573)

	Medical, Healthcare, and Nursing
	Management (6-10 years)
	Not specified

Standardize of clinical services across all physical and virtual channels.
Liaise with all clinical specialties to compile, review and maintain medical guidelines and protocols.
Work with Medical, Nursing, IT, Operations and Comms teams to deliver a comprehensive service.
Collaborate with the Quality department in setting and maintaining clinical standards.
Participate in clinical leadership and clinical management meetings and initiatives.
Generate, prepare and present regular reports related to clinical guidelines, protocols and audits.
Deliver training and/or orientation sessions related to clinical guidelines, protocols and documentation.
Coordinate, lead and attend face-to-face and virtual meetings to provide hands-on support to clinicians, nurses and other healthcare professionals.
Foster multi-disciplinary work and team meetings to enrich clinical work.
Maintain continuous, regular, structured reviews of the Electronic Medical Records for completeness of documentation, medical and coding accuracy and efficiency.
Audit physician-billing practices against documentation in the medical record to ensure compliance with rules, and regulations.
Complete periodic clinical audits.
Perform technical audits and justify the reasons for rejected cases to facilitate the reconciliation process with insurers.
Align with fraud waste and abuse reduction initiatives and leading resultant initiatives and projects.
Advise and provide suggestions on UI enhancements of the EMR

Bachelor's Degree in Medicine/Pharmaceutical from a reputable university.
Post graduate studies in Quality, Business or related majors.
5-10 years of experience in Healthcare sector.
Minimum 3 years in data quality related to Medical auditing in HealthCare/ Medical Insurance/ Hospital/ or TPA company.
Effective communication of analyses (both verbal and written).
Good command of statistics and data interpretation.
Experience in Project Management and Organization.
Knowledge of current GDPR and other issues.
Excellent command of English.