1,996 Clinical Internship jobs in India

Job Profile Summary
Position Purpose: Define and develop standard and custom formularies for assigned plan.

Education/Experience: Bachelor’s degree or advanced degree (, in pharmacy. + years of mail order, retail, hospital or managed care pharmacy experience or + years of pharmacy residency program experience.

Licenses/Certifications: Current state’s Pharmacist license with no restrictions.

Responsibilities
• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
• Monitor prior authorization requests
• Provide clinical support to internal departments and address clinical related questions
• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
• Develop and implement programs designed to impact DUR for both Medicaid and Medicare
• Develop, implement, and maintain policies and procedures for the pharmacy department
• Participate in the coordination of the Medicare MTM program
• Assist case management team with members including clinical rounds presentations

EEO:

“

Location: Remote/ Looking for candidates in Eastern and Central time zones (Preferred: highly prefer Indiana license -to help appeals with local Indiana pharmacy team)

SHIFT: – pm (no OT requirements)

Duration: + months, Possibly extend but no conversion at this time. Subject to change

Job Description: Job Profile Summary
Position Purpose: Define and develop standard and custom formularies for assigned plan.

Education/Experience: Bachelor’s degree or advanced degree (, in pharmacy. + years of mail order, retail, hospital or managed care pharmacy experience or + years of pharmacy residency program experience.

Licenses/Certifications: Current state’s Pharmacist license with no restrictions.

Job Purpose: Clinical pharmacist supporting outreach to providers and pharmacies to drive pharmacy gap closure for quality programs. Pharmacist will also assist with pharmacy appeal reviews. Individual work-assigned specific tasks to complete each day. Surrounding team members that will be able to help support if needed. Performance expectations/metrics include completing targeted outreach; completed medication appeal reviews timely.

Responsibilities
• Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
• Monitor prior authorization requests
• Provide clinical support to internal departments and address clinical related questions
• Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
• Develop and implement programs designed to impact DUR for both Medicaid and Medicare
• Develop, implement, and maintain policies and procedures for the pharmacy department
• Participate in the coordination of the Medicare MTM program
• Assist case management team with members including clinical rounds presentations. Candidate Requirements Education/Certification Required: bachelor or doctor of pharmacy degree Preferred: Licensure Required: Pharmacist license Preferred: highly prefer Indiana license -to help appeals with local Indiana pharmacy team Years of experience required: + years of experience and + year of residency.

Disqualifiers: Not having a steady work history, looking for longevity

Additional qualities to look for: multi-tasking and ability to manage multiple given assignments throughout each day.

Doctor and Master in Managment degree with 3-5 years experince in Multispeciality Hospital.
- Maintaining/Supervising all department as per Hospital protocols.
- Ensure all day-to-day actives regards hospital Clinial and Non-Clinical.
- Person should have understanding of Medical Services, Hosptal Complincies.

Interview Time: 1pm (Mon - Sat) brings with Bio-Data and documents.

Pay: ₹35,000.00 - ₹48,000.00 per month

Schedule:

- Day shift
- Evening shift
- Morning shift

MBBS and Master in Managment degree with 10 years experince in Multispeciality Hospital.
- Maintaining/Supervising all department as per Hospital protocols.
- Ensure all day-to-day actives regards hospital Clinial and Non-Clinical.
- Person should have understanding of Medical Services, Hosptal Complincies.
- Supervision of all M.L.C cases from admission to discharge. And All M.L.C. 24 x 7 to be done as name of RMO.
- Training to CMO related to MLC matter and clinical training to MO
- Issue medical certificate and indoor case papers as per hospital policy

Interview Time: 1pm (Mon - Fri) brings with Bio-Data and documents.

Pay: ₹50,000.00 - ₹125,000.00 per month

Schedule:

- Day shift

COO/CEO/ Super Speicality & Speciality Doctors Needed for Hospitals in Hyderabad & Andhra Pradesh

Front Office / Billing / OT Technicians & Nurses needed for Hyderabad Location

Suitable profiles shall be contacted.

Pay: ₹35,000.00 - ₹500,000.00 per month

Schedule:

- Day shift
- Morning shift
- Night shift
- Rotational shift

Work Location: In person

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases. Work is frequently completed without established procedures
**Primary Responsibilities:**
+ Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT/diagnosis codes, CMC guideline along with referring to client specific guidelines and member policies
+ Adherence to state and federal compliance policies and contract compliance
+ Assist the prospective team with special projects and reporting
+ May act as a resource for others
+ May coordinate others' activities
+ Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
**Required Qualifications:**
+ Medical degree - BHMS/BAMS/BUMS/BPT/MPT
+ B.Sc Nursing and BDS with 1+ years of corporate experience
+ 6+ months of experience (Fresher's in BPT / MPT / BHMS/ BAMS/ BUMS can also apply)
+ Extensive work experience within own function
+ Proven attention to detail & quality focused
+ Proven good analytical & comprehension skills
+ Proven ability to work independently
**Preferred Qualifications:**
+ Claims processing experience
+ Health Insurance knowledge, managed care experience
+ Knowledge of US Healthcare and coding
+ Medical record familiarity
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
This process works on identifying Fraud, Waste and Abuse between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve or deny claims and Identify provider aberrant behavior patterns. The associates prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with referring to client specific guidelines and member policies.
Fraud is intentionally misrepresenting or concealing facts to obtain something of value. The complete definition has three primary components:
+ Intentional dishonest action or misrepresentation of fact
+ Committed by a person or entity
+ With knowledge that dishonest action or misrepresentation could result in an inappropriate gain or benefit
This definition applies to all persons and all entities. However, there are special rules around intentional misrepresentations to Government programs such as Medicare and Medicaid, or TRICARE.
Waste includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources.
Abuse includes any practice that results in the provision of services that:
+ Are not medically necessary
+ Do not meet professionally recognized standards for health care
+ Are not fairly priced
**Primary Responsibilities:**
+ Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with referring to client specific guidelines and member policies
+ Adherence to state and federal compliance policies and contract compliance
+ Assist the prospective team with special projects and reporting
+ Coordinate with all team members and share recent process related updates
+ Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
**Required Qualifications:**
+ Medical degree - MBBS or BHMS or BAMS or BUMS or BPT or MPT or BDS
+ Graduate - "Results awaited" candidates will not be accepted
+ Good knowledge on MS - Word and MS - Excel
+ Attention to detail and Quality focused
**Preferred Qualifications:**
+ Knowledge of US Healthcare and coding
+ Proven high attention to detail which translates to 100% quality of work performed
+ Proven ready to support the business during peak volumes as & when needed
+ Proven good written and verbal communication skills.
+ Proven team player
+ Proven good analytical skills. He should have the ability to understand the mistakes and correct the same
+ Proven flexibility - Ready to accommodate the working hours and working days depending on the Business Need
+ 100% work from office
+ Demonstrated ability to work independently without close supervision
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Business Segment or Department:**
CPI - Commercial Payment Integrity
**Purpose of Job**
This process works on identifying Fraud, Waste and Abuse between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve or deny claims and Identify provider aberrant behavior patterns. The associates prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes, CMS guideline along with referring to client specific guidelines and member policies.
Fraud is intentionally misrepresenting or concealing facts to obtain something of value. The complete definition has three primary components:
+ Intentional dishonest action or misrepresentation of fact
+ Committed by a person or entity
+ With knowledge that dishonest action or misrepresentation could result in an inappropriate gain or benefit
This definition applies to all persons and all entities. However, there are special rules around intentional misrepresentations to Government programs such as Medicare and Medicaid, or TRICARE.
Waste includes inaccurate payments for services, such as unintentional duplicate payments, and can include inappropriate utilization and/or inefficient use of resources.
Abuse includes any practice that results in the provision of services that:
+ Are not medically necessary
+ Do not meet professionally recognized standards for health care
+ Are not fairly priced
**Primary Responsibilities:**
+ Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT or diagnosis codes , CMS guideline along with referring to client specific guidelines and member policies
+ Adherence to state and federal compliance policies and contract compliance
+ Assist the prospective team with special projects and reporting
+ Coordinate with all team members and share recent process related updates.
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
**Required Qualifications:**
+ Medical degree - MBBS or BHMS or BAMS or BUMS or BPT or MPT or BDS
+ Graduate - "Results awaited" candidates will not be accepted
+ Good knowledge on MS - Word and MS - Excel
+ Attention to detail and Quality focused
**Preferred Qualifications:**
+ Knowledge of US Healthcare and coding
+ Proven high attention to detail which translates to 100% quality of work performed
+ Proven ready to support the business during peak volumes as & when needed
+ Proven good written and verbal communication skills.
+ Proven team player
+ Proven good analytical skills. He should have the ability to understand the mistakes and correct the same
+ Proven flexibility - Ready to accommodate the working hours and working days depending on the Business Need
+ 100% work from office
+ Demonstrated ability to work independently without close supervision
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._