USRN - Subject Matter Expert - Makati - Optum

    Optum
    Optum Makati

    1 araw ang nakalipas

    Pangkalusugan
    Paglalarawan

    The Clinical Subject Matter Expert (SME) is the clinical anchor and primary

    knowledge resource for our Medication Therapy Management (MTM) program.

    Working closely with the Operations Manager and Team Supervisors, the SME ensures the

    highest standard of clinical accuracy and patient safety. You will serve as the ultimate escalation

    point for complex pharmacological queries, conduct quality audits, and drive continuous

    education. By facilitating peer-to-peer knowledge sharing and updating clinical resources, you

    will empower our Clinical Nurses to confidently manage complex medication regimens for US-based M&R patients.

    Note: This role requires working night shifts in Manila to align with US Central Standard Time

    (rotating shifts between 8:00 AM and 8:00 PM CST, Monday through Friday).

    Key Responsibilities

    • Clinical Escalations: Act as the primary resource for Clinical Nurses encountering complex medication profiles, drug interactions, or difficult disease state management scenarios.
    • Quality Assurance & Auditing: Conduct regular clinical audits of patient documentation and recorded calls to ensure strict adherence to the 5 Core Elements of MTM Services and internal quality standards.
    • Training & Nesting Support: Partner with the training team to support new hireonboarding (nesting phase), ensuring clinical concepts are accurately translated intopractical, telephonic workflows.
    • Knowledge Management: Develop, update, and maintain clinical job aids, processflows, and FAQs.
    • Continuous Education: Design and facilitate ongoing clinical upskilling sessions, fostering a culture of employee-generated learning where nurses share unique case studies and best practices.
    • Cross-Functional Collaboration: Work alongside US counterparts and clinical

    pharmacists to clarify guidelines and implement new clinical directives from the client.

    Required Qualifications

    • Active, unrestricted USRN and PHRN Licenses
    • 3+ years of robust clinical nursing experience, with a strong foundation in pharmacology, geriatrics, or chronic disease management.
    • 1–2 years of experience in a clinical BPO setting, preferably in a QA, training, or senior clinical role.
    • Deep, demonstrable understanding of Medication Therapy Management (MTM) protocols, Pharmacy Benefit Management (PBM), or Retrospective Drug Utilization Review.
    • Advanced ability to navigate complex EHR/EMR platforms and

    interpret prescription claims data.

    What We Offer

    • Market Competitive Pay Levels
    • Retirement Plan
    • Medical Plan (HMO) from Day 1 of employment
    • Dental, Medical, and Optical Reimbursements
    • Life and Disability Insurance
    • Paid Time-Off Benefits
    • Sick Leave Conversion
    • Tuition Fee Reimbursement
    • Employee Assistance Program (EAP)
    • Annual Performance Based Merit Increases
    • Employee Recognition
    • Training and Staff Development
    • Employee Referral Program
    • Employee Volunteerism Opportunity
    • All Mandatory Statutory Benefits

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Makati City