Executive Medical Audit
About the role
We have an exciting opportunity for an Executive Medical Audit to join the team in Cyberjaya, Selangor. In this contract role, you will be responsible for conducting audits, investigations, and quality improvement initiatives to ensure provider compliance with company guidelines and standards. Responsibilities include preparing reports, implementing corrective actions, developing guidelines, and conducting training.
What you'll be doing
- Support and assist in clinical audits onsite/offsite to ensure the delivery of services by providers follows the guidelines/manual/SOP set by the Company.
- Identify and conduct investigations on suspected fraud cases or complaint cases.
- Prepare a case report and compile the related documents in relation to the investigation conducted.
- Discuss case recommendations with the superior and follow up on the corrective measures to be taken with relevant parties.
- Provide recommendations to relevant departments based on case investigation findings.
- Conduct onsite audits and other related audits on ProtectHealth providers to ensure conformance and adherence to the stipulated SOPs, Guidelines, and Manuals set by the Company.
- Carry out onsite/virtual training with selected providers as part of quality improvement initiatives.
- Assist the department in developing related guidelines and SOPs.
- Manage, collaborate, assist, and liaise with other internal or external parties when necessary to plan and implement related quality improvement strategies.
- Performs other related duties as required and assigned.
What we're looking for
- A bachelor’s degree preferably in medicine, pharmacy, nursing, or any science/audit-related field.
- Minimum 3 years of experience in medical auditing or a related field within the healthcare industry
- Strong communication skills, both written and verbal.
- Proficiency in using Microsoft Excel, PowerPoint, and Word.
- Ability to work independently and collaboratively within a team.
- Have your own transport and be able to travel.
- Organised and self-motivated.
- Ability to manage multiple tasks and meet the demands of a fast-paced environment with changing priorities.
Travel Requirements
- This position may require occasional travel to different healthcare facilities, provider offices, or offsite locations to conduct on-site audits, attend training sessions, or collaborate with external partners.
- Travel frequency may vary but is generally expected to be 50% of the working time.
- Travel expenses, including accommodation and transportation, will be provided or reimbursed as per company policies.
The list above is not exhaustive and can be modified to meet departmental/organisational needs.
Due to the volume of applications, we regret that only shortlisted candidates will be notified.
Employer questions
- What's your expected monthly basic salary?
- Are you willing to travel for this role when required?
- How much notice are you required to give your current employer?
- How many years' experience do you have as an Audit Executive?
Company profile
Incorporated on 19 December 2016, ProtectHealth Corporation Sdn Bhd (ProtectHealth) is a wholly-owned subsidiary of ProtectHealth Malaysia, established under the Ministry of Health, Malaysia (MOH).
As a not-for-profit company, ProtectHealth coordinates, administers and manages initiatives related to financing healthcare services as mandated by MOH.
Company information
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