Internal Medicine Specialist
3 days ago
MedGrocer's digitally-enabled "medicine-as-a-service" platforms are used by hundreds of employers and pharma companies. Our end-to-end medicine/vaccine programs, telehealth services, and onsite medical staff serve a million Filipinos every year. MedGrocer is one of the more established Filipino Health Tech startups.
The Internal Medicine Specialistaddresses medical case escalations. They coordinate with stakeholders to verify and resolve HMO claims.
Key Responsibilities
- Assess medical cases to evaluate coverage of HMO benefits and segregation of Maximum Benefit Limits (MBL)
- Coordinate with health providers and fellow medical resource specialists to resolve HMO claims escalations
- Audit voice and video consults for quality checks and appropriateness of care
- Provide recommendations to improve training materials, simplify system processes for escalation, and streamline intake forms and outputs
- Provide monthly and quarterly reports on volume, types, channels, and sources of escalations
- Attend telehealth calls for patients as needed
Minimum Qualifications
- Must be a Diplomate of Internal Medicine
- Sub-specialization and hospital affiliation is an advantage
- Must be willing to attend onsite training in Makati
Perks and Benefits
- Hybrid work set-up
- Flexible schedule
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