Team Lead - Quality | Clinical Pre-Authorization @ Omega Healthcare

Job Description

Job Title : Team Lead Quality | Clinical Pre-Authorization

Locations: Hyderabad

Experience Required: 6 - 10 years

Qualifications

• Graduate/Postgraduate in Life Sciences, Pharmacy, Nursing, or related field
  
• 6 - 10 yrs in Clinical Pre-Auth/US Healthcare; min. 23 yrs in Quality & Team handling
  
• Strong knowledge of US healthcare processes, ICD/CPT codes, compliance standards
  
• Good analytical, communication, and stakeholder management skills
  
• Proficiency in MS Office & quality reporting tools
  

Key Responsibility Areas (KRAs)

• Lead and manage Quality team for Clinical Pre-Auth operations
  
• Conduct audits, monitor accuracy, and ensure compliance with client SLAs
  
• Identify gaps, drive CAPA, and lead process improvement initiatives
  
• Perform RCA for errors/escalations and share feedback with Ops/Training teams
  
• Prepare quality dashboards/reports and present to management/clients
  
• Deliver refresher trainings, mentor team members, and build quality culture
  

Employment Type: Full-time

Salary: As per industry standards

How to Apply:
Apply directly via Naukri, email your resume to Sh**************e@om*****s.com, or share your profile via Whatsapp@9004744***

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Rs 0 - 50K PM Rs 50K - 1 LPA Rs 1.0 - 1.5 LPA Rs 1.5 - 2.0 LPA Rs 2.0 - 2.5 LPA Rs 2.5 - 3.0 LPA Rs 3.0 - 3.5 LPA Rs 3.5 - 4.0 LPA Rs 4.0 - 4.5 LPA Rs 4.5 - 5.0 LPA Rs 5 - 6 LPA Rs 6 - 7 LPA Rs 7 - 8 LPA Rs 8 - 9 LPA Rs 9 - 10 LPA Rs 10 - 12 LPA Rs 12 - 14 LPA Rs 14 - 16 LPA Rs 16 - 18 LPA Rs 18 - 20 LPA Rs 20 - 22 LPA Rs 22 - 24 LPA Rs 24 - 26 LPA Rs 26 - 28 LPA Rs 28 - 30 LPA Rs 30 - 32 LPA Rs 32 - 34 LPA Rs 34 - 36 LPA Rs 36 - 38 LPA Rs 38 - 40 LPA Rs 40 - 42 LPA Rs 42 - 44 LPA Rs 44 - 46 LPA Rs 46 - 48 LPA Rs 48 - 50 LPA Rs 50 - 75 LPA Rs 75 Lakh - 1C PA Rs 1 Crore+ PA

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Accounting / Finance Advertising / MR / PR / Events Agriculture / Dairy Animation / Multimedia Architecture / Interior Design Astrology Automobile / Auto Ancillaries / Auto Components Aviation / Airline / Aerospace / Aeronautical Banking / Financial Services / Broking BPO / Call Center / ITeS Brewery / Distillery Broadcasting Cement / Building Material Chemical / Petro / Plastic / Rubber / Glass Consumer Electronics / Appliances / Durables Courier / Transportation / Freight Defence / Government Education / Teaching / Training Electricals / Switchgears Engineering / Construction / Cement / Metals Environment / Waste Management Export / Import / Trading Facility Management Fertilizers / Pesticides FMCG / Foods / Beverage Food Processing Furnishings / Ceramics / Sanitaryware / Electricals Gems / Jewellery Gifts / Toys / Stationary Government / Departmental Heat Ventilation / Air Conditioning Hotel / Restaurant Industrial Design Industrial Products / Heavy Machinery Insurance Internet / E-Commerce IT - 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Keyskills:   Authorization Revenue Cycle Management AR Calling US Healthcare Denials RCM