Providers Utilization Officer

2 weeks ago


Metro Manila Philippines Asalus Corporation (IntelliCare) Full time

Job Description Responsible in providing support to the medical group heads/managers in the guiding and implementing the probe process and carry out directives, in accordance with the group agreed plan. Duties and Responsibilities Assist various responsible centers on the recurrence of trending practice by our medical providers, in coordination with probe data analytics Receive and share data information to internal and external clients Liaise and attend meetings with medical providers and other group/department under evaluation. Responsible in providing status and progress report of medical providers under probe to team leader. Responsible in providing status update of leads and concerns to various sources or dependencies via email, telephone call, sms etc (internal or external) Collate and review data for probing Prepare and file memos, letters and signed agreements from probed providers Provide corrective measures, reconcile, record and analyze medical providers unusual utilizations. Review, negotiate medical provider rates and report the same to immediate officers as required to enable effective business operations and relationship Prepares reconciliation list to be forwarded at claims & treasury for possible amount of recovery. Provide updates/progress report to team leader regarding status of medical providers under evaluation. Endorse resolved concerns to data analyst 1 for record monitoring Actively participate and provide full support to company’s current and proposed project. Perform other duties as assigned. Apply through our career page and enjoy the hiring process in the comfort of your home For more info about our company and other lists of openings, kindly check our website at or visit our Facebook careers page at . #J-18808-Ljbffr


  • utility staff

    2 days ago


    Binondo, Metro Manila, Philippines Shirt Asia Apparel (Smilee Apparel) Full time ₱15,000 - ₱30,000 per year

    Our growing company is seeking to hire a Utility/Housekeepers who will be responsible for cleaning assigned areas according to company standards to ensure a clean environment for clients, superiors and fellow employees.Responsibilities:Duties include cleaning offices, floors, washrooms and dusting surfaces throughout the company premises.Refilling supplies,...


  • , Bulacan, Philippines Avanteph Staffing and Consultancy Inc. Full time

    We are seeking a Provider Relations Officer for a reputable healthcare facility in Bulacan. The role involves serving as the primary liaison between the organization and its network of healthcare providers. The Provider Relations Officer ensures smooth coordination between providers, hospital management, and internal departments while maintaining strong...

  • utility

    2 days ago


    Ermita, Metro Manila, Philippines Top1Movers Worldwide Inc. Full time

    General Maintenance and Housekeeping: Maintain cleanliness and orderliness of office premises, work areas, restrooms, and common spaces. Sweep, mop, dust, and disinfect floors, walls, and furniture regularly. Collect and dispose of trash properly and ensure waste bins are clean and emptied regularly.Support in Office or Facility Operations: Assist in setting...

  • Utility Clerk

    2 days ago


    Manila, National Capital Region, Philippines Asticom Technology Inc Full time

    We are looking for a reliable and hardworking Utility Clerk to provide general support in maintaining cleanliness, orderliness, and efficiency in the workplace. The Utility Clerk will be responsible for assisting in cleaning, repairs, deliveries, and other maintenance-related duties to ensure smooth daily operations. The ideal candidate is dependable,...


  • Philippines Remote Raven Full time ₱1,200,000 - ₱2,400,000 per year

    The Utilization Review Specialist is responsible for managing all aspects of the utilization review process, including preauthorization, Single Case Agreements (SCA), continued authorizations, and collaboration with clinical staff to ensure documentation meets insurance requirements. This role is crucial in securing necessary authorizations for various...


  • , Metro Manila, Philippines Sound Decisions Full time

    Our client is seeking an experienced Office Manager to oversee the smooth day-to-day operations of our office while coordinating across multiple projects and departments. This role requires exceptional organizational skills, strong leadership, and the ability to manage priorities in a fast-paced environment. The ideal candidate will have proven experience...


  • Manila, Philippines New York Global Consultants Inc. (NYGCI) Full time

    1 day ago Be among the first 25 applicants Requirements Required Skill: Expert proficiency in Oracle Utilities Customer to Meter C2M SPL. Strong understanding of application development methodologies and best practices. Experience with database management and SQL for data manipulation. Familiarity with software development tools and version control systems....


  • Manila, Philippines Health Business Solutions LLC Full time

    JOB SUMMARY We are seeking a skilled Utilization Review Coordinator (URC) to oversee patient insurance certification, compliance with governmental regulations related to hospital stays, and the prevention of denials. Embedded within our utilization review management platform are clinical criteria guidelines, streamlining the review and documentation process....


  • Manila, National Capital Region, Philippines Megaworld Corporation Full time ₱400,000 - ₱800,000 per year

    Graduate of Mechanical Engineering course with applicable professional licenseWith more than 3 years of relevant work experienceExperience on coordination with water utility providers or related industryExcellent communication and interpersonal skills to collaborate with various utility providers and other stake holdersKnowledge of utility systems,...


  • Manila, National Capital Region, Philippines Extenteam Inc. Full time ₱400,000 - ₱600,000 per year

    We are looking for a Utility Billing Associatefor a Property management client of ours.  As a Utility Bills Associate, you will be responsible for ensuring that all utility invoices are accurately processed and recorded for each property. You will work closely with the client to maintain organized records, enter invoices into AppFolio with the correct...