Operations Manager for Appeals - PHRN
Gratitude IncOperations Manager for Appeals - PHRN
Job Description
Key Skills
0 candidate(s) have already applied for this Job. Apply now
Job Title: Operations Manager for Appeals - PHRN
Shift: Night shift
Work Set-up: On-site in Bridgetowne, Quezon City
Salary range: 120K to 150K
Start date: Dec 31, 2025/ ASAP
LOB DESCRIPTION: Medical necessity review for appeals (Claims denied due to medical necessity)
JOB SUMMARY:
The Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals, ensuring compliance with industry standards and regulatory requirements. The role involves close collaboration with various stakeholders to drive performance and maintain high-quality standards.
QUALIFICATIONS:
• Bachelor's Degree in Nursing with an active and valid license in PHRN
• Must have at least 1 or 2 years in a managerial role handling leaders/ TLs/ Supervisors
• Experience in managing teams handling Clinical Appeals
• Experience in handling appeals, utilization review, or related healthcare management functions
• Excellent verbal and written communication skills
• Willingness to work on-site with flexible schedules, including US hours and holidays
KEY RESPONSIBILITIES:
• Oversee daily operations and ensure compliance with SLAs and regulatory standards.
• Developer and implement process improvement initiatives.
• Collaborate with internal and client stakeholders to enhance service delivery and maintain accurate staffing.
Role
Branch Management
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Functional Area
Retail / Consumer / Commercial
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
Get the Best Jobs
on your Fingertips
Similar Jobs
0 - 10 Year(s)
Confidential
Manila, Philippines
Microsoft Azure DevOps Developer
Gratitude Inc4 - 10 Year(s)
Confidential
Manila, Philippines
CUSTOMER SERVICE REPRESENTATIVE
Gratitude Inc0 - 3 Year(s)
Confidential
Manila, Philippines
CSR Retirement LOB (SALARY UP TO 50k PHP)
Gratitude Inc2 - 3 Year(s)
45 - 50 Thousand p.m
Manila, Philippines
1 - 2 Year(s)
75 - 85 Thousand p.m
Manila, Philippines
Customer service representative -Mandarin speakers
Gratitude Inc0 - 5 Year(s)
70 - 75 Thousand p.m
Manila, Philippines
Project Control Officer/ PCO Analyst
Gratitude Inc2 - 5 Year(s)
30 - 50 Thousand p.m
Manila, Philippines
WNS bridgetowne :CSR -Travel/Financial Account
Gratitude Inc1 - 10 Year(s)
25 - 30 Thousand p.m
Manila, Philippines
Shipping and Logistics Account.
Gratitude Inc0 - 2 Year(s)
10 - 15 Thousand p.m
Manila, Philippines
Retail Account
Gratitude Inc1 - 2 Year(s)
10 - 20 Thousand p.m
Manila, Philippines