SHAI

Company Description At SHAI, we empower our healthcare customers to excel in what they do. Our clients consistently appreciate the seamless support, collaboration, and added value we bring to their business. With 30 years of industry experience, we have perfected the art of blending technology, thought leadership, and execution to make a meaningful impact in everything we deliver. Role Description This is a full-time on-site role for an IPDRG at SHAI, located in Chennai. The IPDRG will be responsible for analyzing and interpreting healthcare data, coding patient information, ensuring compliance with healthcare regulations, and maintaining accurate electronic health records. Daily tasks include collaborating with healthcare teams, conducting data verification, and preparing reports. The role requires attention to detail and adherence to industry standards. Qualifications Proficiency in data analysis and interpretation Experience in medical coding and maintaining electronic health records Knowledge of healthcare regulations and compliance standards Strong analytical skills and attention to detail Excellent communication and collaboration abilities A bachelor’s degree in Health Information Management, Healthcare Administration, or a related field Prior experience in the healthcare industry is a plus Show more Show less

Job Description: We are looking for a motivated and detail-oriented Utilization Management Specialist to join our team. As a fresher In this role, you will help review medical information to ensure that healthcare services are necessary and follow best practices. You will support the approval of healthcare services to ensure they are cost-effective and meet patient needs. Key Functions: Review outpatient procedures, inpatient admissions, home health, and behavioral health services to check if they are necessary. Work with providers and medical directors to get prior authorization and plan for case reviews when needed. Collaborate with clinical staff to ensure appropriate care and resource use. Participate in quality improvement projects and help develop clinical guidelines. Monitor and report on utilization trends to management Requirements Preferred Skills Familiarity with MCG/Inter Qual Guidelines is a plus. Keep up-to-date with regulations and maintain organized records of all activities. Experience with Medicaid, Medicare, and Managed Care is helpful. Strong knowledge of anatomy, physiology, and medical terminology. Proficient in MS Office applications. Excellent communication skills and ability to work both independently and in a team. Strong analytical and problem-solving skills. Qualifications : Candidates with a Bachelor's Degree in Nursing are eligible to apply Freshers can also apply. Candidates already having work experience in the Hospital Field is added advantage. Benefits Perks and Benefits Five Days of working Saturday and Sunday fixed Week off Double Wages (If working on Saturday/Sunday) Both 2-way Cab facility Available for only Night Shift

We are seeking a motivated and detail-oriented Utilization Management Specialist to join our team. In this role, you will play a crucial part in reviewing medical information to ensure the necessity of healthcare services and adherence to best practices. Your responsibilities will include supporting the approval of cost-effective healthcare services that align with patient needs. You will be tasked with reviewing outpatient procedures, inpatient admissions, home health, and behavioral health services to determine their necessity. Collaborating with providers and medical directors to obtain prior authorization and plan case reviews when necessary will be an essential aspect of your role. Additionally, working closely with clinical staff to guarantee appropriate care and resource utilization is vital. As a Utilization Management Specialist, you will actively participate in quality improvement projects and contribute to the development of clinical guidelines. Monitoring and reporting on utilization trends to management will be a key responsibility to ensure efficient healthcare service delivery. Preferred Skills for this role include familiarity with MCG/Inter Qual Guidelines, up-to-date knowledge of regulations, and maintaining well-organized records of all activities. Experience with Medicaid, Medicare, and Managed Care is advantageous, along with a strong understanding of anatomy, physiology, and medical terminology. Proficiency in MS Office applications, excellent communication skills for effective teamwork, and the ability to work both independently and collaboratively are essential. Strong analytical and problem-solving skills are also desirable. Candidates applying for this position should hold a Bachelor's Degree in Nursing, while freshers are encouraged to apply. Previous work experience in the Hospital Field is considered an added advantage. Benefits offered for this position include a five-day workweek, with fixed weekends off (Saturday and Sunday). Employees working on weekends are eligible for double wages, and a two-way cab facility is available for night shifts.,