Business Analyst (with RN experience) As a Business Analyst at Pointwest, you will play a vital role in bridging business needs and technology solutions. You’ll work closely with clients and technical teams to analyze requirements, design workflows,
Req ID: 379940 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are
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.
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,
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,
Join our dynamic team and make a meaningful impact in the healthcare industry. Enjoy competitive benefits upon hire, ongoing professional development, and the satisfaction of helping others every day. Take the next step in your career
Hire Type: Permanent Shift: Midshift (1PM-10PM) Location: Science Hub Tower 1, Mckinley Hills Taguig / One Ecom MOA, Pasay City About the Role The HR Business Partner (HRBP) serves as a trusted advisor to business leaders,
Knowles Electronics (Philippines) Corporation is seeking a Company Nurse to support occupational health, clinic operations, employee wellness programs, and regulatory compliance within our manufacturing facility. Key Responsibilities Manage daily clinic operations and provide nursing care to
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
The Opportunity This is not a traditional nursing management role. As Manager – Clinical Nursing , you will lead the delivery of high-quality, compassionate, and patient-centered care across inpatient nursing units while ensuring operational excellence, staff
Clinical Documentation Improvement (CDI) specialists are responsible for improving the overall integrity of medical records documentation. Their responsibilities can vary based on an individuals specific job, company, or industry. Here are some general clinical documentation improvement
Job Responsibilities: Field incoming clinical questions from team members and reply quickly Develop resources regarding clinical items for internal and external customers Assist with coordination of regulatory activities and onsite audits Counsel travel clinicians on incidents
The US Registered Nurse (USRN) will support clinical review and healthcare operations by evaluating medical records, validating clinical necessity, and ensuring compliance with payer and regulatory standards. This role focuses on supporting accurate reimbursement outcomes through
Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Roles
Req ID: 379940 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently
Quality Assurance Nurse 1. Review Initial Assessment and Reassessment Packets Verify that all required documentation is complete, accurate, and included before assessment. 2. Initial Assessment Requirements: Initial Assessment Clinical Records Physicians Report (LIC 602) Medication Records
Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Roles
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
Position Summary The Transitional Care Management Nurse is a U.S.-licensed Registered Nurse responsible for delivering high-quality, post-discharge care coordination services to patients across multiple programs. This role focuses on ensuring safe transitions of care, reducing readmissions,
Role Type: 12 Months Temporary Line Manager: Commercial Payments Team Lead Function : Purchase to Pay Duty Post: Taguig, Metro Manila Payment Specialist (Temporary ) Are you detail-oriented and passionate about delivering accurate, timely, and compliant