Roving Doctor

<div><p>Managing a group of hospitals to ensure that inpatient customers are receiving optimal healthcare within agreed quality parameters. The Roving Doctor provides medical expertise across multiple sites ensuring high-quality patient care, compliance with medical standards, and support for clinical teams. This role involves regular travel, flexibility, and the ability to work in diverse healthcare settings.</p><h3>Insurance Offices and Provider Management</h3><ul><li>Ensure approvals and rejections are mutually agreed upon.</li><li>Verify that invoicing aligns with the terms of the agreement.</li></ul><h3>Customer Care</h3><ul><li>Maintain communication with inpatients and their families to enhance the company’s image.</li><li>Proactively address and resolve any issues faced by customers or their families at the hospital.</li></ul><h3>Hospital Admissions</h3><ul><li>Provide accurate and detailed daily updates on all inpatient cases, including justifications for decisions made.</li></ul><h3>Reporting</h3><ul><li>Submit reports on savings and fraud to Medical Approvals Manager.</li><li>Notify Provider Relations of high-value claim cases.</li><li>Market Practices reporting</li><li>Proactively gather and report insights on provider and competitor practices to the regional team.</li></ul><h3>Compliance and Ethics</h3><ul><li>Ensure all medical practices align with local healthcare regulations and ethical standards.</li><li>Promote patient safety and confidentiality across all facilities.</li></ul><h3>Medical Auditing and Oversight</h3><ul><li>Review patient files for accuracy, completeness, and compliance with organizational standards.</li><li>Identify gaps in documentation and recommend corrective actions.</li><li>Support the approvals and claims team in reviewing and validating medical necessity for services.</li></ul><h3>Education</h3><ul><li>Bachelor’s degree in medicine.</li><li>Preferably diploma or masters in a clinical specialty.</li></ul><h3>Experience</h3><ul><li>2 years of experience in same roving role or active medical practice.</li><li>Familiarity with health insurance industry practices, policies, and regulations.</li></ul><h3>Personal Attributes / Skills</h3><ul><li>Strong diagnostic and clinical decision-making skills.</li><li>Excellent communication and interpersonal skills.</li><li>Ability to work independently and adapt to diverse environments.</li><li>Proficiency in electronic medical record (EMR) systems and reporting tools.</li><li>Familiarity with healthcare policies, medical insurance processes, and claims adjudication.</li><li>Willingness to travel frequently and work flexible hours.</li></ul><h3>Others</h3><ul><li>Excellent Communication and negotiation skills.</li></ul></div>#J-18808-Ljbffr