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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.
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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
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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.
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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