MAManipal Cigna Insurance Group
Medical Advisor
Bangalore ₹1-4 LPA Posted 13 May 2025
FULL TIME
clinical services
Fraud Detection
Case Management
Quality Improvement
medical management
Job Description
- Part of a clinical team that provides evidence based medical management services to customers worldwide
- Give evidence-based advice on medical claims, taking into account compliance, internationally accepted protocols and local and/or regional customs and regulations.
- Support and monitor the case management, disease management and other clinical services and assure quality of performance against QA standards to promote optimal service delivery and ensure accurate statistical data and reports. Give advice on appropriate corrective action if necessary.
- Assist in fraud detection.
- Assist is the coordination of processes for improving quality of care and health outcomes for specifically delineated projects or populations. Excellent communication and facilitation skills are keys to success.
- Assist and support the team in cost containment, assist in projects and service delivery to meet goals.
- Work together with the team on quality improvement and clinical management projects within Clinical Operations
- Serves as a resource/educator regarding specific areas of expertise. Able to create and implement appropriate educational clinical programs content for internal and external audiences and link with Cigna University resources.
- Other duties as assigned.