Health Clinical Services Senior Manager - USRN
Gratitude IncHealth Clinical Services Senior Manager - USRN
Job Description
Key Skills
0 candidate(s) have already applied for this Job. Apply now
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
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.
SKILLS 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.
Interested and qualified candidates should send their CV to esther.igweonu@gratitudeindia.com
Role
Any Other
Timings
Night Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Functional Area
Any Other
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
QA Analyst (HCM)
Gratitude Inc2 - 10 Year(s)
30 - 40 Thousand p.m
Manila, Philippines
HGS Bridgertowne -CSR Financial account
Gratitude Inc1 - 24 Year(s)
20 - 25 Thousand p.m
Manila, Philippines
Order Management Opertions Lead
Gratitude Inc2 - 5 Year(s)
25 - 35 Thousand p.m
Manila, Philippines
Training Quality Manager (PHRN/USRN)
Gratitude Inc1 - 3 Year(s)
120 - 150 Thousand p.m
Manila, Philippines
CGI pasid
Gratitude Inc1 - 33 Year(s)
20 - 30 Thousand p.m
Manila, Philippines
Customer service representative
Gratitude Inc0 - 1 Year(s)
25 - 30 Thousand p.m
Manila, Philippines
Trainer/Senior Trainer – Credit Card Operations
Gratitude Inc2 - 3 Year(s)
35 - 40 Thousand p.m
Manila, Philippines
CSR -Healthcare Account -Alldigitech Company
Gratitude Inc0 - 17 Year(s)
20 - 30 Thousand p.m
Manila, Philippines
WNS & Alldigitech company Hiring
Gratitude Inc0 - 2 Year(s)
Confidential
Manila, Philippines
1 - 21 Year(s)
25 - 35 Thousand p.m
Manila, Philippines