Manager/senior Manager, Medical Consultant

TheCignaGroup LLC

Hong Kong
**
Manage pre-authorization process
Review medical claims for appropriateness
Assess treatment medical necessity
** The Cigna Group is seeking a Manager/Senior Manager, Medical Consultant in Hong Kong to oversee medical decision-making processes, ensuring adherence to clinical guidelines while managing pre-authorization and claims review services. The ideal candidate will have a medical degree and at least five years of clinical experience, with a focus on improving cost-effectiveness and health outcomes. **

Job Summary

  • This role provides functional expertise on cases ensuring that medical decisions adhere to Cigna's global clinical guidelines.
  • The Medical Consultant will manage pre-authorization and claims review services to ensure cost-effectiveness and appropriateness of treatment.
  • The position requires engaging and developing relations with key healthcare providers locally to improve customer experience and optimize cost containment efforts.

Matching Summary

Match Score: 75

** The Cigna Group is seeking a Manager/Senior Manager, Medical Consultant in Hong Kong to oversee medical decision-making processes, ensuring adherence to clinical guidelines while managing pre-authorization and claims review services. The ideal candidate will have a medical degree and at least five years of clinical experience, with a focus on improving cost-effectiveness and health outcomes. **

Skills & Requirements

Must-have

  • Manage pre-authorization process
  • Review medical claims for appropriateness
  • Assess treatment medical necessity
  • Partner with business divisions
  • Develop relations with healthcare providers

Nice-to-have

  • Ability to work in ambiguous situations
  • Culturally sensitive to diverse workforce
  • Strong analytical capabilities focus on outcomes
  • Comfortable working with all management levels

Key Requirements

  • Bachelor of Medicine Bachelor of Surgery (MBBS) degree or equivalent
  • Minimum 5 years clinical experience
  • Completed rotations in Family Medicine General Surgery General Medicine Orthopedics Obstetrics Gynaecology
  • Fluent in English and Chinese Cantonese written and spoken
  • Familiar with the healthcare system in Hong Kong

Work Rights

Not specified

Tailored Resume

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