Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doingyour life's best work.(sm)
Specialty Medical Guidance Program provides prior authorization for utilization management and reporting service to help reduce medical expenses and simplify the provider experience. Caller (either Physician or staff from Physician office) calls the helpline to secure prior authorization for oncology and non-oncology specialty drugs including chemotherapy regimens.
Primary Responsibilities:
Take Calls from providers regarding chemotherapy eligibility
Take Calls from Providers, or staff from Providers' Clinic that are requesting Prior Authorization for Specialty Drugs including Chemo Drugs
Take Calls from Providers, or staff from Providers' Clinic that are requesting for status of existing request
Outbound Calls during MBMNow outage
Make outbound provider calls to complete the down time form
Enter the request into the system for the prior authorization after verifying HIPAA
Update Basic Information in MBMNow: the system will give the final result either PA approved system approved or need to go through manual review
Enter accurate documentation in ICUE/MBMNow
Fax via RightFax confirmation page to requesting provider offices
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
PHRN with active license
Minimum 1 year of bedside clinical experience (other LOBs would require minimum of 2 years)
Excellent Communication skills
With intermediate skills in Microsoft excel
Team player, very good customer service and interpersonal skills
Solid clinical acumen
Computer literate
Preferred Qualifications:
Preferably with working internet connection of at least 15 mbps in case of working from home. The following options are also available:
- Corporate internet subsidy for those within available and valid serviceable locations, subject to Company Policy
- Onsite work for those who are amenable to drive or commute to our office locations
Careers with Optum.Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to doyour life's best work.(sm)
Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.
Job Keywords: Philippine Registered Nurse, Nurse, PHRN, PH RN, PH Registered Nurse, Registered Nurse, RN, Taguig City, NCR, National Capital Region
