**Mission or Objective:** ---------------------- Conduct medical evaluations in accordance with policy conditions regarding the claimed illness, providing timely, high-quality responses and contributing to the company's profitability by authorizing claims in alignment with the contracted service. **Function \- Responsibility:** ------------------------------- 1\.\- Perform medical and administrative analysis of received information according to established protocols, ensuring diagnostic consistency versus compliance with policy conditions (60%) 2\.\- Supervise auxiliary services related to insured care (services outside hospitals) or supplies associated with the previously authorized illness for treatment (30%) 3\.\- Record information from issued medical evaluations in logs, helping maintain up-to-date departmental performance indicators (10%)**Education:** ---------------- Bachelor's degree or Engineering degree (certified) in Medicine**Academic Knowledge \- Certifications:** ------------------------------------------------ * Medical license * Additional certification: CELE, TOEIC, IELTS, TOEFL. (certified) **Experience and applicable responsibilities:** ----------------------------------------------------- * General policy conditions at GMM * Evaluation processes (Mandatory) Applies exclusively to GMM and International Evaluation Management **Areas or Experience in:** --------------------------- General Practitioner * General practitioner * GMM Evaluation
Juan García
Indeed · HR
Juan García
Indeed · HR
