Laya Healthcare is seeking a Registered General Nurse (RGN) with a minimum of 3 years of clinical experience to join our Medical Practice Team. This role focuses on pre-authorisation of medical treatments, evaluating claims based on medical guidelines, and providing clinical advice and training.
Desirable personal qualities include the ability to work under pressure, attention to detail, tolerance for reviewing, analysing and interpreting data, and being a confident decision maker. Good communication and presentation skills are necessary.
This role reports to the Medical Practice Team Leader.
ROLES & RESPONSIBILITIES:
* Pre-authorisation of requests for Medical Procedures & high cost drugs nationally and internationally.
* Approve requests for treatment in line with the Schedule of Procedures for Professional fees.
* Provide clinical training to non-clinical personnel as required.
* Provide clinical advice and support to the business.
* Liaise with clinicians and hospital finance teams to manage treatment requests.
* Responsibility for reporting and analysing practice in Claims Pre-authorisation Activity.
* Update monthly reports on pre-authorisation.
* Draft letters, papers and presentations in relation to the clinical area as required.
* Awareness of market changes in the medical field.
* Completion of any ad hoc duties which may be requested as part of the daily running of the Medical Practice Team.
EXPERIENCE:
* A registered General Nurse with a minimum of 3 years hands-on clinical experience.
* Computer skills and presentation skills are beneficial.
* Ability to be proactive and decisive in analysing practice and implementing better ways of working that will create efficiency.
* Need to be confident in dealing with clinicians.
SENIORITY LEVEL:
Mid-Senior level
EMPLOYMENT TYPE:
Temporary
JOB FUNCTION:
Administrative, Health Care Provider, and Other
INDUSTRIES:
Staffing and Recruiting, Health and Human Services, and Insurance
#J-18808-Ljbffr