Sr. Specialist - Case management - UR 1 (Bangkok, TH, 10330)

Manage concurrent review and case management activities for pre-authorized hospital admission cases, ensuring decisions align with medical necessity guidelines and utilization management policies. Assess clinical information to confirm appropriateness and adherence to treatment and cost-effective care pathways, monitor high-cost cases, and escalate issues to the medical team. Support clinical governance and compliance, perform ICD coding for claims processing, and prepare cost-saving and productivity reports.