We provide managed healthcare services to corporate clients ranging from SMEs to MNCs.

Responsibilities:

1. Medical/Regulatory Oversight

• Serve as Clinical Governance Officer (CGO) for all our clinics
• Lead audit preparation and execution to ensure regulatory compliance
• Act as the ordering doctor for laboratory and imaging tests, including prompt responses to critical results
• Address general medical regulations queries from internal and external stakeholders
• Lead initiatives to manage and reduce the cost of medical claims through clinical review, provider negotiation, and strategic interventions.
• Conduct and oversee claims audits, identifying patterns of overutilization or fraud, waste, and abuse (FWA).
• Monitor provider performance and billing behavior to identify and mitigate fraud, waste, and abuse (FWA); initiate corrective actions where necessary.
• Develop internal cost contai...