Job Description
Field Doctors Lead
The Field Doctor Lead is responsible for conducting on-site hospital visits to medically assess inpatient cases and evaluate the clinical justification for admissions and admission extensions. The role focuses on ensuring medical necessity, optimizing length of stay, supporting timely and safe discharges, and generating measurable cost savings for the TPA and its clients.
What you do
Clinical Review & Case Assessment
•Review inpatient cases extracted from the system according to defined roving and case selection criteria.
•Conduct on-site hospital visits to assess the medical necessity of admissions and requested extensions of stay.
•Evaluate diagnosis, treatment plans, investigations, progress notes, and clinical outcomes against medical guidelines and policy coverage.
•Determine whether continued hospitalization is clinically justified or if alternative care or discharge is approp...
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