- PH Registered nurses to review workers compensation claims with serious injury and that need surgery/lengthy treatments, create a return-to-work plan, work with various stakeholders (medical providers, injured worker, employer, attorney) to track the treatment plan and help bring the injured worker back to work.
- Nurses have continuous communication with injured workers and as a single point of contact for the injured workers
- Uses clinical/nursing skills to determine whether all aspects of a patient's care, at every level, are medically necessary and appropriately delivered.
- Sends letters as needed to prescribing physician(s) and refers to physician advisor as necessary
- Responsible for accurate comprehensive documentation of case management activities in case management system.
- Uses clinical/nursing skills to help coordinate the individual's treatment program while maximizing quality and cost-effectiveness of care including direction of care to preferred provider networks where applicable.
- Addresses need for job description and appropriately discusses with employer, injured employee and/or provider. Works with employers on modifications to job duties based on medical limitations and the employee's functional assessment.
- Responsible for helping to ensure injured employees receive appropriate level and intensity of care through use of medical and disability duration guidelines, directly related to the compensable injury and/or assist adjusters in managing medical treatment to drive resolution.
- Communicates effectively with claims adjuster, client, vendor, supervisor, and other parties as needed to coordinate appropriate medical care and return to work.
- Performs clinical assessment via information in medical/pharmacy reports and case files; assesses client's situation to include psychosocial needs, cultural implications, and support systems in place.
- Objectively and critically assesses all information related to the current treatment plan to identify barriers, clarify, or determine realistic goals and objectives, and seek potential alternatives.
- Partners with the adjuster to develop medical resolution strategies to achieve maximal medical improvement or the appropriate outcome.
- Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim.
- Engage specialty resources as needed to achieve optimal resolution (behavioral health program, physician advisor, peer reviews, medical director).
- Partner with adjuster to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves.
- Keeps current with market trends and demands.
- Performs other functionally related duties as assigned.
- Bachelor's degree in nursing (BSN)
- Active unrestricted RN license that can be validated thru PRC website
- 1-2 years of relevant Clinical experience in any medical/surgical department, Orthopedic, Medical/Surgical ICU, Coronary Care Unit (CCU), Rehabilitation, Emergency department
- Written and verbal fluency in English
- Candidate should be willing to work onsite (BGC)
- Candidate should be willing to work in US operation hours
-
Disability Case Manager
Natagpuan sa: Talent PH A C2 - 5 araw ang nakalipas
Recruiter PH Taguig, Pilipinas Permanent- Adjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational information- Coordinate appropriate interventions including, but not limited to: Independent Medical Evaluations, Funct ...
-
Disability Case Manager
Natagpuan sa: Trabajos diarios PH C2 - 3 araw ang nakalipas
Recruiter PH Taguig City, Pilipinas- Adjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational information · - Coordinate appropriate interventions including, but not limited to: Independent Medical Evaluations, Fu ...
-
Disability Case Manager
Natagpuan sa: Trabajos diarios PH C2 - 3 araw ang nakalipas
RecruiterPH Taguig City, PilipinasWhat will you do? · o Adjudicate disability for eligibility of short and long-term benefits. This includes reviewing and analyzing contractual, medical, functional and occupational information · o Coordinate appropriate interventions including, but not limited to: Independent Med ...
-
Case and Document Management Specialist
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Holcim Philippines Inc. Taguig, PilipinasThe Case and Document Management Specialist is responsible for assisting vendors on their submission of billing invoice and identifying exceptions, discrepancies and adjustments affecting immediate posting and subsequent payment. · Responsibilities: · Reviews vendor documents for ...
-
Business Analysis Associate I
Natagpuan sa: Foundit PH A2 - 7 oras ang nakalipas
JPMorgan Chase Bank, N.A. Taguig, Pilipinas Buong orasJob Description : · The CCB Remediation and Corrections Consumer Banking Project Manager is responsible for the end to end management of correction case activities for the Consumer Banking book of work. · As a Business Analysis Associate I - Project Manager within the Consumer an ...
-
HR Support Representative
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Medtronic Cardiac and Vascular Taguig, PilipinasCareers that Change Lives · At AskHR in Medtronic, our goal is to provide a best-in-class employee experience, providing a standard level of care to our customers and drive operational excellence. We are the first point of contact for employees and managers to receive solutions a ...
-
HR Support Representative
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Medtronic Cardiac and Vascular Taguig, PilipinasCareers that Change Lives · At AskHR in Medtronic, our goal is to provide a best-in-class employee experience, providing a standard level of care to our customers and drive operational excellence. We are the first point of contact for employees and managers to receive solutions a ...
-
Operations Manager
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Gratitude Philippines Taguig, PilipinasEducational Background: B.S Nursing · Qualifications · 8+ years of related experience or equivalent combination of education and experience · required to include 2+ years of direct clinical care OR 2+ years of case · management/utilization management required. · Bachelor's de ...
-
Head of Legal
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
John Clements Consultants Inc Taguig, PilipinasJob Role : Head of LegalJob Description : · Company Overview : · A leading provider of financial services, specializing in pawnshop, money changer and remittance services. With a strong commitment to customer satisfaction and innovation, we have established a significant presence ...
-
Legal Assistant
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Carpo Law & Associates Taguig, Pilipinas Buong orasRequirements: · With a Bachelor's Degree preferably in Legal Management, Political Science, or other allied courses; · With 1 to 2 years of legal and/or law firm work experience; · Knowledgeable with litigation and legal procedures and requirements is a must; · With good communic ...
-
Data Quality Tester
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Collabera Digital Taguig, PilipinasROLES AND RESPONSIBILITIES · Does (The tasks / responsibilities that the role performs to address requirements in Key Result Areas) · Create detailed test cases that matches business requirements to ensure data quality. · Perform data quality checking for ad-hoc data extractio ...
-
Clinical Denials Clinician
Natagpuan sa: Foundit PH A2 - 5 araw ang nakalipas
Conifer Health Solutions Taguig, PilipinasThe Clinical Denials Clinician of AR Management is responsible for recovering revenue through a.) intelligent and ethical investigation of disputed/denied clinical claims, b.) verifying eligibility for clinical review, and c.) preparation and documentation of appeals based on ind ...
-
Hiring Sourcing and Procurement Process Manager
Natagpuan sa: Foundit PH A2 - 3 araw ang nakalipas
Neksjob Philippines Taguig, Pilipinas Buong orasSourcing and Procurement Process Manager · Key Responsibilities · Preferred Work onsite / Taguig City · Understand client business, priorities, and leadership agenda. · Co-create and drive innovation agenda for clients, establishing trust as a C-suite advisor. · Lead sourcing and ...
-
Employee Lifecycle Representative
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Medtronic Cardiac and Vascular Taguig, PilipinasCareers that Change Lives · Bold thinking. Bolder actions. We are Medtronic. · At AskHR in Medtronic, our goal is to provide a best-in-class employee experience, providing a standard level of care to our customers and drive operational excellence. We are the first point of conta ...
-
Sourcing and Procurement Process Manager
Natagpuan sa: Foundit PH A2 - 3 araw ang nakalipas
Neksjob Philippines Taguig, PilipinasSourcing and Procurement Process Manager - Taguig · Key Responsibilities · Understand client business, priorities, and leadership agenda. · Co-create and drive innovation agenda for clients, establishing trust as a C-suite advisor. · Lead sourcing and procurement transformation p ...
-
Occupational Health Nurse
Natagpuan sa: Foundit PH A2 - 5 araw ang nakalipas
Metacom Careers Taguig, PilipinasFresh graduates of BS Nursing or with no clinical experience are accepted · Job Responsibility: · Conduct health assessments, screenings, and physical examinations as required. · Provide first aid and emergency care to employees as needed. · Maintain health records and confidenti ...
-
Occuppational Health Nurse
Natagpuan sa: Foundit PH A2 - 6 araw ang nakalipas
Metacom Careers Taguig, PilipinasFresh graduates of BS Nursing or with no clinical experience are accepted · Job Responsibility: · Conduct health assessments, screenings, and physical examinations as required. · Provide first aid and emergency care to employees as needed. · Maintain health records and confidenti ...
-
Process Manager
Natagpuan sa: Foundit PH A2 - 3 araw ang nakalipas
Neksjob Philippines Taguig, PilipinasExperience Requirements: · Minimum 8+ years for Manager and 13+ years for Senior Manager in top-tier consulting or Sourcing and Procurement functions. · Demonstrated experience in large-scale sourcing and procurement projects across various industries. · Expertise in business pro ...
-
Wealth/Asset Management Manager
Natagpuan sa: Foundit PH A2 - 3 araw ang nakalipas
Neksjob Philippines Taguig, PilipinasWealth / Asset Management Manager · Location: Taguig City, Metro Manila · As a Manager/Senior Manager, focus on overseeing client engagements and driving sales in Enterprise Asset Management (EAM). Responsibilities include identifying and resolving EAM challenges, developing busi ...
-
Supply Chain Process Consultant
Natagpuan sa: Foundit PH A2 - 3 araw ang nakalipas
Neksjob Philippines Taguig, Pilipinas PermanentExperience Requirements · MBA or Master's in relevant field preferred. · Bachelor's in Engineering with a robust academic record. · 5-8 years of post-qualification experience. · In-depth experience in S/4HANA solution design, business case development, and testing/deployment. · 2 ...
Medical Case Manager - Taguig, Pilipinas - Gratitude Philippines
