The Government of the Federated States of Micronesia (FSM) seeks a well-qualified individual to fill the position of Medical Consultant at the Office of MiCare.
Duties & Responsibilities:
Develop and implement a training program designed to upgrade medical claim review and to increase performance confidence of the Utilization Staff; address performance shortfalls of the Utilization Division Staff and recommends improvements; continue to review cases for referrals to ensure that each recommended case requires an off-island tertiary medical treatments as stipulated in the MiCare regulations; monitors proper coordination of patients referrals to avoid delay and inconveniences to eligible patients, taking into consideration the most economical means of sending BA patients to Philippines; draft letter for Administrator’s review and signature for any issues related to Utilization activities, including those related to reconciliation, non-compliances, RUV’s and Free Schedule, etc; participates in the referral committee reviews in the State Hospital; negotiate for pricing & discount conditions or direction health care providers; directly supervise Utilization Division staff in Manila and its operation; performs other duties as assigned.
Qualification Requirements:
Graduation from an accredited college or university with a medical doctor degree or medical credential from a recognized government authority to practice medicine. Four (4) years of experience in utilization review in health insurance. Must be able to obtain medical license to practice medicine in the Federated States of Micronesia.
Salary:
Salary of $30,000 per annum depending upon qualifications and experience.
To apply:
Send application, resume, credentials, and other supporting documents to the following addresses:
MiCare Office Personnel Office
FSM National Government P.O.Box PS-35
Kolonia, Pohnpei FM 96941 Palikir, Pohnpei FM 96941
Tel #: (691)320-2549 Tel #: (691)320-2618
Email: personnel@personnel.gov.fm
The Office of Personnel will be accepting application/resume from July 17, 2024 until filled.
THE FSM AN EQUAL OPPORTUNITY EMPLOYER
