USRN - Health Clinical Services Senior Manager

Gratitude Inc

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3 days ago

USRN - Health Clinical Services Senior Manager

12-13 Year(s)

150 - 200 Thousand p.m

Manila (Taguig)

Job Description

Key Skills

USRN Utilization Review Supervisory Experience

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---ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE---

JOB TITLE: Health Clinical Services Senior Manager - USRN WORK SET UP: Onsite in Taguig WORK SHIFT: Night shift Rest Day: Weekends

Location: Taguig Uptown Bonifacio Tower 3 Salary budget: 150K - 250K (Confidential) (Salary is confidential, but sharing a range here for sourcing purposes only and NEVER share to your candidates and, only give them a hint that once they will be selected, the final salary offer will depends to the client and project they will be assigned)

Ready to join Accenture’s team of empowered people? We’re looking for candidates with the following skills and experience for this role. Do you fit the profile? If you do, we’d love to hear from you! In adherence to Accenture’s process of Identity Verification, your resume or CV must include your photo to ensure the accuracy of your application.

Responsibilities:

Oversees staff whose teams’ primary duties may include, but are not limited to: • Conducts pre-service, concurrent, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.

• Service requests may be from inbound calls and facsimile. • Outbound calls to the provider may be required to gather additional information that may be needed. • Other staff responsibilities may include review and analysis of post-service claims utilizing the member’s benefit contract and health plan guidelines. • Completes review of pended claims post-service for either Medical Necessity or Contractual Reviews.

SKILL AND QUALIFICATIONS:

• At least 12 years of relevant experience and 10 years of supervisory experience • Holds current and unrestricted US Registered Nurse license. No state-specific RN licensure required. • BPO experience should be any account (Health account experience is only a plus, but not required) • Work Background/Experience in General: Must be open to BPO & Non-BPO Experience • Open for those applicants who are currently in Philippines and already have the right to live and work in this country are eligible for this role • Must have no recent or active application with Accenture • Should not be a job hopper who only works for less than a year per company

RECRUITMENT PROCESS:

• Endorse for validation • Screening with CV Reviewer • Endorse for CV screening through Workday, along with the HRI toolkit, FCV and CV • For reviewing with the client

REMINDER: Please do not include the name of the client in all your job postings. Kindly ensure that you upload the CVs of your candidates in a PDF format with screening notes based on the JD provided.

PRE-SCREENING QUESTIONS:

Do you have an active USRN license?

How much is your last drawn salary?

How much is your salary expectation?

Are you amenable to working onsite set up with a shifting schedule in Taguig?

Role

Nursing - Management

Timings

Night Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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.

Precious Ubeng

Recruiter - Gratitude Inc

NA, nigeria

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