We Are Looking For Nurse ConsultantsIndustry: BPO (Healthcare)Job Title: Nurse ConsultantLocation: Infopark, Kakkanad, KochiExperience: Minimum of 3 years clinical experience mandatoryQualification: BSC NursingShift: Night Shift (6PM to 3AM, cab will be provided)Salary: 35,000/- to 50,000/- Per MonthShould have excellent fluency in English.Job RoleProvide comprehensive clinical review of complaints and appeals filed by providers with the use of appropriate resources and guidelines to ensure cost-effective delivery of health services.Supports identification and review of appropriate case types in compliance with the clinical guidelines.Promotes/supports quality effectiveness of Healthcare Services.Fundamental Components & Physical Requirements (include but are not limited to)Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit determinations.Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.Condenses complex information into a clear and precise clinical picture while working independently.Data gathering requires navigation through multiple system applications.Utilizes client systems to build, research and enter member information.Applies clinical guidelines in determining clinical decisions.Experience in patient management in a clinical setting is a requirement to help with clinical understanding.Accurately applies review requirements to assure case is reviewed by a practitioner with clinical expertise for the issue at hand.Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g. Claim Administrators, Plan Sponsors, and 3rd party payers as well as Member, Family, and Healthcare Team Members respectively).Protects the confidentiality of member information and adheres to company policies regarding.Ability to understand and interpret clinical laboratory results and familiarity with clinical conditions and its management is required.RequirementsQualification: Bachelor of Science in NursingExperience: Min. of 3 years clinical experience.Should have excellent fluency in English.Willingness to work in shifts/Night Shift (6PM to 3AM).BenefitsCab (pickup & drop)ESI, PF, Health insuranceBasket of allowances#J-18808-Ljbffr