Team Lead - Quality | Clinical Pre-Authorization

6 - 10 years

7 - 11 Lacs

Posted:9 hours ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Job Title :

Locations:

Experience Required:

Qualifications

  • Graduate/Postgraduate in Life Sciences, Pharmacy, Nursing, or related field
  • 6 - 10 yrs in Clinical Pre-Auth/US Healthcare; min. 23 yrs in Quality & Team handling
  • Strong knowledge of US healthcare processes, ICD/CPT codes, compliance standards
  • Good analytical, communication, and stakeholder management skills
  • Proficiency in MS Office & quality reporting tools

Key Responsibility Areas (KRAs)

  • Lead and manage Quality team for Clinical Pre-Auth operations
  • Conduct audits, monitor accuracy, and ensure compliance with client SLAs
  • Identify gaps, drive CAPA, and lead process improvement initiatives
  • Perform RCA for errors/escalations and share feedback with Ops/Training teams
  • Prepare quality dashboards/reports and present to management/clients
  • Deliver refresher trainings, mentor team members, and build quality culture

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