Case Management Doctor

2 days ago

Jakarta, Jakarta, Indonesia Halodoc Full time $40,000 - $60,000 per year

Key Responsibilities:

  • Oversee case management and guarantee letters (GL) to ensure SLA/TAT compliance.
  • Provide medical support to case management and claims teams.
  • Review medical necessity, treatment plans, and billing for cost containment.
  • Liaise with providers, clients, and internal teams on medical escalations.
  • Ensure clinical quality, support training, and contribute to process improvements.
  • Lead medical-related issue resolution and service enhancements.

Qualifications:

  • Medical Doctor (MD) with valid STR & SIP (Indonesia).
  • Min. 2 years' experience in health insurance, TPA, hospital utilization, or case management.
  • Strong knowledge of clinical pathways, treatment protocols, and insurance policies.
  • Excellent communication, analytical, and problem-solving skills.
  • Willing to be on-call for urgent/critical cases.

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