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Medical Billing Manager
4 araw ang nakalipas
Vector Outsourcing Solutions Philippines Philippines, Pilipinas Buong orasSalary: 50,000 PHP- 70,000/ month · Job Description: · Supervise and lead a team of medical billing specialists, providing guidance, training, and support as needed. · Communicate and facilitate special projects, reports, and requests from client · Assign tasks, set priorities, a ...
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Specjalista ds. Wsparcia Budowy
4 araw ang nakalipas
Fluor Corporation Philippines, Pilipinas Buong orasJob Description · Fluor Gliwice jest czci Fluor Corporation z siedzib w USA, dostawcy profesjonalnych i technicznych rozwiza, z zakresu doradztwa technicznego, projektowania i zarzdzania projektami inwestycyjnymi. · Fluor w Gliwicach dziaa w ramach linii biznesowej Urban Solution ...
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Systems Engineer
4 araw ang nakalipas
Techno Global Team Philippines, Pilipinas Buong orasAs our Systems Engineer,your skills in Desktop Support, Server Management and Customer Management will be a great value as you work together with our lively and goal-driven team. · Full Job Description: · Get access to cutting edge tools and technology and work with our MSP partn ...
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Junior Solar Engineer
4 araw ang nakalipas
Buskowitz Energy Philippines, Pilipinas Buong orasJoin Us · Embrace a Brighter Future with Our Renewable Energy Team · Are you passionate about sustainability and eager to contribute to a cleaner, greener world Are you ready to harness the power of the sun to drive positive change and make a meaningful impact Look no further We ...
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Medical Devices Lead Auditor
4 araw ang nakalipas
SGS (Malaysia) Sdn Bhd Philippines, Pilipinas Buong orasJob Description · We have an excellent new opportunity fora Medical Device Lead Auditor to join our global organization.The successful candidate will be responsible for planning and conducting audits against the manufacturing of medical devices, in accordance with ISO 13485, MDD ...
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Nurse Medical Mgmt I
4 araw ang nakalipas
Carelon Global Solutions Philippines, Pilipinas Buong orasDescription: · Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the me ...
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Utilization Review Nurse
4 araw ang nakalipas
Nezda Technologies, Inc. Philippines, Pilipinas Buong orasNezda is currently looking for Utilization Review Nurse (USRN) - WFH candidates. · Qualifications: · Active USRN and PHRN License · With at least 1 Year Clinical or Hospital Experience · Job Description: · Reviews service requests to ensure compliance with applicable criteria, me ...
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Purchasing Secretary for Medical Supplies
4 araw ang nakalipas
RemoteVA Philippines, Pilipinas Buong orasWe are looking for a detail-oriented and organized Secretary to manage the procurement of medical supplies and handle accounts payable using QuickBooks Desktop. The primary responsibility of this role will be purchasing medical supplies, requiring prior experience in medical supp ...
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Utilization Review Nurse
4 araw ang nakalipas
Nezda Technologies, Inc. Philippines, Pilipinas Buong orasNezda is currently hiring for Utilization Review Nurse (USRN). · Qualifications: · Active USRN and PHRN License · With at least 1 Year Clinical or Hospital Experience · Job Description: · Reviews service requests to ensure compliance with applicable criteria, medical policy, and ...
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Company Nurse
4 araw ang nakalipas
PAL Express Philippines, Pilipinas Buong orasReasons Why We Stand Out · One of the leading airlines in the Philippines. · Get a chance to enjoy travel perks for you and for your family. · A collaborative work culture and environment. · Know More About The Qualifications · Graduate of BS Nursing · Open to fresh graduates w ...
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Virtual Medical Receptionist
4 araw ang nakalipas
Outforce Philippines, Pilipinas Buong orasAs a Virtual Medical Receptionist, you will work directly with our clients doctors (Ophthalmology) and other medical professionals based in the USA. · We help our clients improve workflow, save time, and remove the burden of in-room documentation. A Virtual Medical Receptionist c ...
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Personal Injury Law Case Manager
3 araw ang nakalipas
Virtual Champs Global, Inc Philippines, Pilipinas Buong orasHiring Post: Case Manager · Industry: Personal Injury Law · Hours: 40hrs/week · Number of head/s: 4 · Responsibilities: · Communicate with insurance companies to open and manage claims · Provide support and guidance to clients throughout the legal process · Schedule appointments ...
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Network and Wellness Coordinator
4 araw ang nakalipas
Allianz PNB Life Philippines, Pilipinas Buong orasOperations · Purpose of the Role · As a Network and Wellness Coordinator you will oversee agreements with and monitors performance of hospitals/clinics/doctors and other medical providers for the medical service needs of AZPNBL clients. You will also identify possible medical pro ...
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HR Associate
3 araw ang nakalipas
The Medical City Clinic Philippines, Pilipinas Buong orasCompany Description · The Medical City Clinic (TMC Clinic) is a premier private outpatient ambulatory clinic located in Pasig, Philippines. With a network of 60+ clinics strategically located in Metro Manila and provincial areas of Luzon, TMC Clinic brings accessible and high-qua ...
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PHRN and Medical Allied Graduates
4 araw ang nakalipas
Nezda Technologies, Inc. Philippines, Pilipinas Buong orasNezda is currently hiring for PHRN and Medical Allied Graduates for Healthcare Account. · Competitive Salary Package · Location: Ortigas, Pasig & Cebu · Qualifications: · PHRN or medical allied graduate · With Utilization management / review experience · Prior Authorization exper ...
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Medical Records Specialist
3 araw ang nakalipas
CoreBridge Solutions Philippines, Pilipinas Buong orasLocation: Fully Remote (Must be based in the Philippines) · Work Hours: Full-Time, Tuesday to Saturday: 12:00 AM – 9:00 AM (Philippine Time) · Applicants must have experience in handling medical records, healthcare administration, or a related medical field. · About CoreBridge So ...
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Medical Sales Representative
4 araw ang nakalipas
Business Innovations Gateway Inc. Philippines, Pilipinas Buong orasResponsibilities · Promoting and selling company health products, specifically medications, to doctors, pharmacists, and other relevant healthcare professionals within Ethical Operations such as hospitals, doctors' clinics, etc. · Scheduling appointments with doctors, pharmacists ...
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Senior Sales Representative-ultrasound-Philippines
4 araw ang nakalipas
Mindray Philippines, Pilipinas Buong orasResponsibilities · Explore, develop new clients, and consolidate sales network in assigned territories · Analyse customers' needs and develop solutions · Create and maintain database of key accounts · Develop relationship with key accounts · Provide advice and support to tenders ...
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Nutritionist-Dietitian
4 araw ang nakalipas
The Premier Medical Center Philippines, Pilipinas Buong orasCompany Description · The Premier Medical Center is a state-of-the-art 150-bed tertiary hospital situated in Parañaque that provides excellent and affordable medical services to its constituents. The hospital is accessible via the Sucat and C5 Extension roads, making it easy to r ...
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Clinical Supervisor
4 araw ang nakalipas
The Medical City Philippines, Pilipinas Buong orasAt The Medical City, we bridge the gap between Filipinos and health services. An ambitious mission, and to achieve it we need the bright minds of our country's young leaders. Young leaders who are willing to inspire a generation and take on the challenges we are faced today. The ...
Manager Medical Management - Philippines, Pilipinas - Carelon Global Solutions
Paglalarawan
Description:
Responsible to manage a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources.
Primary duties may include, but are not limited to:Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.
Areas managed may include authorizing inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources.
Applies clinical knowledge to work with facilities and providers for care-coordination. May also manage appeals for services denied. Hires, trains, coaches, counsels, and evaluates performance of direct reports.Requires current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States, except in government business where it is preferred, and 5 years acute care clinical experience or any combination of education and experience, which would provide an equivalent background.
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. The following are level distinctions not required for posting.This level typically reflects a new manager, one managing a singular function, a manager with a smaller span of management, or one located in a unit where a higher level of management exists.
For URAC accredited areas the following applies:
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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