Medical Advisor

Medical Advisor – Job Description Add expected salary to your profile for insights Are you passionate about healthcare and ready to make a meaningful impact? We’re looking for a dynamic individual to join our Medical Affairs team as a Medical Advisor , where you’ll play a key role in managing medical claims, liaising with panel doctors, and supporting clinical operations. What You’ll Be Doing As a Medical Advisor, you’ll be at the heart of our medical operations. Your responsibilities will include: Medical/Regulatory Oversight – Serve as Clinical Governance Officer (CGO) for all IHP clinics Medical/Regulatory Oversight – Lead audit preparation and execution to ensure regulatory compliance Medical/Regulatory Oversight – Act as the ordering doctor for laboratory and imaging tests, including prompt responses to critical results Medical/Regulatory Oversight – Address general medical regulations queries from internal and external stakeholders Medical/Regulatory Oversight – Lead initiatives to manage and reduce the cost of medical claims through clinical review, provider negotiation, and strategic interventions Medical/Regulatory Oversight – Conduct and oversee claims audits, identifying patterns of overutilization or fraud, waste, and abuse (FWA)Medical/Regulatory Oversight – Monitor provider performance and billing behavior to identify and mitigate fraud, waste, and abuse (FWA); initiate corrective actions where necessary Medical/Regulatory Oversight – Develop internal cost containment SOPs and workflows in collaboration with operational teams to streamline claims processing and medical adjudication Medical/Regulatory Oversight – Act as the primary client-facing representative for all matters related to medical cost containment Medical/Regulatory Oversight – Prepare regular reports and presentations for leadership and clients, highlighting key cost drivers, trends, and opportunities for optimization Clinical Support – Perform regular medication reviews and sign off for VIP, ensuring safe and effective treatment plans Claims, Letter of Guarantee (LOG) and Pre-Authorization – Act as the final medical escalation point for claims, LOG, and pre-authorization within IHP Medical/Regulatory Oversight – Develop and refine general guidelines and definitions for medical reimbursable claims Medical/Regulatory Oversight – Provide strategic support to the Claims and LOG teams in developing and enhancing STP workflows and overall process improvements Business Development Support – Participate in presentations and stakeholder engagement as a clinical representative Business Development Support – Collaborate on workflow reviews to align clinical operations with BD initiatives Business Development Support – Contribute to the ongoing refinement of IHP’s data analytics, offering client insights and actionable strategies Business Development Support – Provide KIV support for on-site rollout of services Business Development Support – Participation in initiative-based projects as required, including clinical input and representation in BD-related presentations and discussions Chronic disease management program – Involvement in design, execution, and evaluation LPA program – Support for program rollout and medical compliance What You Need to Excel We’re looking for someone who is: Confident and self-motivated Calm under pressure (equanimity)Tech-savvy and adaptable A great communicator with strong interpersonal skills Qualifications & Requirements Medical Degree from a recognized university (MD or MBBS preferred)Minimum 5 years of relevant experience in a TPA or insurance company Willingness to support after-office-hours remotely Willing to travel (Singapore)Why Join Us?Be part of a passionate and collaborative medical team Make a real difference in people’s lives Enjoy a supportive work environment with opportunities for growth Ready to take the next step in your medical career?Apply now and be a part of something meaningfulIntegrated Health Plans Pte Ltd is one of the leading healthcare providers in Asia Pacific region. We provide in healthcare claims processing an integrated solution and a tailored platform to our clients. Whether you are a healthcare provider or a doctor with an independent practice, our services will help you focus on your core job while we take care of the routine work. We believe positively that our commitment in understanding your overall process will helps us understand where exactly we fit in your plan so that we can add significant value to your healthcare practice. Integrated Health Plans Pte Ltd is one of the leading healthcare providers in Asia Pacific region. We provide in healthcare claims processing an integrated solution and a tailored platform to our clients. Whether you are a healthcare provider or a doctor with an independent practice, our services will help you focus on your core job while we take care of the routine work. We believe positively that our commitment in understanding your overall process will helps us understand where exactly we fit in your plan so that we can add significant value to your healthcare practice. To help fast track investigation, please include here any other relevant details that prompted you to report this job ad as fraudulent / misleading / discriminatory / salary below minimum wage. Researching careers? Find all the information and tips you need on career advice. #J-18808-Ljbffr