We are seeking a talented Registered Nurse Consultant to join our MercerWell team at Mercer. This role will be based in the Philippines. This is a hybrid role that has a requirement of working at least
Company:Mercer Description: We are seeking a talented Registered Nurse Consultant to join our MercerWell team at Mercer. This role will be based in the Philippines. This is a hybrid role that has a requirement of working
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member
We are looking for a dedicated Medical Nurse to join our growing team. In this role, you’ll play a vital part in supporting patient care and improving clinical workflows. You will work closely with physicians and
Position Title:Medical Management Specialist I/ PHRN Shift: Job Description: Responsible for providing non-clinical support to the Medical Management and/or Operations areas. Primary duties may include, but are not limited to: Gathers clinical information regarding case and determines
MediCard Phils., Inc. is one of the countrys leading HMO and the only HMO founded and run by Doctors. Since its inception, the concept of service-oriented total health care has been the molding ideal of MediCard.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the
Company Description About Sutherland Artificial Intelligence. Automation. Cloud engineering. Advanced analytics. For business leaders, these are key factors of success. For us, they’re our core expertise. We work with iconic brands worldwide. We bring them a
Performs training and provides subject matter expertise on clinical reviews needed to resolve and process appeals to team members. • Reviews medical records and clinical data to determine medical necessity for services in accordance with policies,
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member
We are looking for a USRN Utilization Review Specialist responsible for reviewing clinical information, medical records, and patient cases to determine the medical necessity, appropriateness, and level of care based on established clinical guidelines and payer requirements.
PHRN - Cebu The Registered Nurse will provide clinical and healthcare support services aligned with operational and quality standards. The role is responsible for delivering patient-centered support through documentation review, clinical coordination, and healthcare process assistance
The Clinical Consultant provides clinical and operational support as a U.S. Healthcare Subject Matter Expert, providing various clinical support services and operational guidance for business processes, to include Case Management, Utilization Management, Clinical Coverage Preservice, Claims and
Work setup: ONSITE / BGC, Taguig within 6 months then transfer to Bridgetowne, QC Work schedule: Nightshift The QA – Clinical Denials is responsible for conducting quality audits of clinical denial reviews, appeal preparation, documentation, coding
Work setup: ONSITE / BGC, Taguig within 6 months then transfer to Bridgetowne, QC Work schedule: Nightshift The QA Team Lead – Clinical Denials provides day-to-day leadership and oversight for the quality assurance function supporting Clinical
Work setup: ONSITE / BGC, Taguig within 6 months then transfer to Bridgetowne, QC Work schedule: Nightshift The Program Manager – Clinical Denials provides strategic and operational leadership for one or more clinical denials programs across
Performs training and provides subject matter expertise on clinical reviews needed to resolve and process appeals to team members. • Reviews medical records and clinical data to determine medical necessity for services in accordance