Job Description:
- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
- Gathers clinical information and applies the appropriate medical necessity criteria / guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care
- Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)
- Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment
- Identifies members who may benefit from care management programs and facilitates referral
- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization
Qualifications:
- Must have an active PRC License
- 2 years of Bedside experience
- Preferably with 6 months BPO Healthcare experience
- Excellent Communication skills
- Willing to participate in our PHRN Academy!
- Temporary WFH
- Must be willing to work onsite if the business/client requires
**Benefits**:
- 50K Recurring bonus
- Sponsored NCLEX Prep and Exam
- 50K Graduation bonus upon completion of NCLEX examination and acquiring of USRN License
- Better salary upon transfer to USRN team
- Free HMO Coverage from Day 1 for you and your Dependents!
- Structured Career path
- Temporary WFH
**Job Types**: Full-time, Permanent
**Salary**: Php30,000.00 - Php35,000.00 per month
**Benefits**:
- Health insurance
- Life insurance
- Opportunities for promotion
- Paid training
- Promotion to permanent employee
Schedule:
- 10 hour shift
- Rotational shift
Supplemental Pay:
- 13th month salary
- Overtime pay
- Yearly bonus
