- Positions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas:
- Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification);
- Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits);
- Clinical Training (planning, coordinating, delivering and evaluating clinical training);
- Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services).
- Clinical Program Management (development, implementation and/or on-going management and administration of a clinical program(s). Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes.)
- Manages and is accountable for professional employees and/or supervisors.
- Impact of work is most often at the local level.
- Bachelor's degree of Nursing + Active USRN License (mainland only)
- Strong Clinical Knowledge base with a minimum of 2 years of Critical Care bedside experience in a tertiary hospital (local/overseas), (areas: ICU, Critical Care Unit, Telemetry, Cardiovascular Intensive Care Unit, Medical Intensive Care Unit, ER)
- At least 3 years supervisory/management position BPO HC experience
- Case Management exp preferred
- 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
- Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
- UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
- We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
- As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
- We're a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.
- Elevate your career with a leading health care company while improving lives.
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ROLE AND RESPONSIBILITIES · Positions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas: · Clinical Interface/Liaison (clinical problem solver with facilities, pro ...
Makati, National Capital Region1 araw ang nakalipas
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The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Come make an impact on the communities we serve as you help us advance health optimization on a global scale. ...
Makati2 linggo ang nakalipas
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The USRN will perform Utilization Management (UM) reviews to ensure medical necessity and compliance with clinical guidelines. They will conduct utilization review for inpatient and outpatient cases assess medical necessity coordinate with providers document review outcomes meet ...
Taguig1 buwan ang nakalipas
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We are looking for a US Registered Nurse (USRN) with Utilization Management experience to support clinical review and authorization processes. · Active PHRN and USRN license (both required) · At least 6 months Utilization Management (UM) experience · Strong English communication ...
Taguig, National Capital Region1 buwan ang nakalipas
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We are looking for a US Registered Nurse (USRN) with Utilization Management experience to support clinical review and authorization processes. The role requires strong clinical judgment, clear communication, · Active PHRN and USRN license (both required) · At least 6 months Utili ...
Taguig1 buwan ang nakalipas
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+ Utilization Management (UM) | DAY SHIFT · Location: Bonifacio Global City (Onsite) · Work Setup: Onsite only +Job summaryA valid USRN license is required for this Utilization Management role. · 6 months to 1 year of UM experience in a BPO setting · ...
Manila1 buwan ang nakalipas
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+Job summary · The primary responsibility of this role is to oversee the process training needs and ensure that transferring of process knowledge, job concepts, and skill honing are delivered effectively through continuous monitoring and improvement of process trainers' skills. · ...
Pasay1 buwan ang nakalipas
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The Clinical Operations Manager oversees Utilization Management (UM) operations. · ...
Pasig1 buwan ang nakalipas
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The primary responsibility of this role is to oversee the process training needs and ensure that transferring of process knowledge job concepts and skill honing are delivered effectively through continuous monitoring and improvement of process trainers' skills. · The role also wo ...
Pasay, National Capital Region1 buwan ang nakalipas
-
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel ...
Taguig1 linggo ang nakalipas
-
Positions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas: · - Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; resolut ...
Taguig, Metro Manila1 linggo ang nakalipas
-
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel ...
Taguig, National Capital Region1 linggo ang nakalipas
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The Case Manager Nurse will regularly liaise with multiple clinical specialties and doctors. · This role also involves consistent interactions with insurance providers, · patients and their families, · legal delegates, · and representatives from other medical care institutions. · ...
Ortigas, Metro Manila1 buwan ang nakalipas
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Position Overview · The primary responsibility of this role is to work with the team of Assistant Managers to oversee the quality of deliverables, manage team relationships, and assess developmental/training needs of employees and processes. · The Lead Assistant Manager is always ...
Pasay3 oras ang nakalipas
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The primary responsibility of this role is to work with the team of Assistant Managers to oversee the quality of deliverables and manage team relationships. · ...
Pasay, National Capital Region1 buwan ang nakalipas
-
The primary responsibility of this role is to work with the team of Assistant Managers to oversee the quality of deliverables · manage team relationships, · and assess developmental/training needs of employees and processes. · ...
Pasay1 buwan ang nakalipas
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The Operations Manager is responsible for overseeing the daily operations of USRN/PHRN teams across multiple accounts or programs. They ensure achievement of KPIs, SLAs, productivity, quality, and turnaround time targets. · Manage workforce planning and capacity forecasting to me ...
Quezon City Central Post Office P1 buwan ang nakalipas
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The primary responsibility of this role is to work with the team of Assistant Managers to oversee the quality of deliverables, manage team relationships, and assess developmental/training needs of employees and processes. · ...
Mall of Asia, Metro Manila1 buwan ang nakalipas
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Position Overview · The primary responsibility of this role is to work with the team of Assistant Managers to oversee the quality of deliverables, manage team relationships, and assess developmental/training needs of employees and processes. · The Lead Assistant Manager is always ...
Pasay4 araw ang nakalipas
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This position oversees staff whose teams' primary duties include conducting reviews to ensure compliance with applicable criteria and medical policy. · ...
Taguig1 buwan ang nakalipas
USRN - Manager - Makati - Optum
Paglalarawan
ROLE AND RESPONSIBILITIES
JOB QUALIFICATIONS
WHAT WE OFFER
WHO WE ARE
Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together
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