医药服务审核主管 - Beijing

仅限注册会员 Beijing, 中国

1周前

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¥18,000 - ¥28,000 (CNY)
该职位来源于猎聘 工作内容: 1.审核特药案件:需对会员提交的医疗资料进行审核:会员身份、医疗真实性,判断会员病症是否符合保险责任或产品责任范围。 2.分析和确认用药合理性,根据会员提供材料,有必要时及时沟通主治医生明确治疗情况,确认后续用药方案及费用。 3.根据药品目录建立医保理赔规则目录、福利用药目录,持续更新药品医保数据或药品福利规则。 4.根据药品目录持续整合相关药品的信息,定期更新药品目录中的药品动态,建设并完善特药药品库。 5.通过整理相关数据,提出审核过程中的问题点和优化建议。 6.完成领导交办的其它工作事项: 任职要求: 1.要求临床医学 ...
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