Medical Resource Manager
2 weeks ago
The position is responsible for:
- Developing, implementing, and creating strategic plans primarily for utilization management;
- Providing leadership among PhilCare's Digimed doctors;
- Effectively communicating with internal and external partners on medical management of cases based on current best practices in the medical field and HMO business.
For utilization management to be effective, the position entails supervision, monitoring, and evaluation of IP, OP, and ER utilization in terms of medical necessity, leading to the creation of specific strategies for cost-efficient regulation and maximization of health insurance benefits. This also entails the application of best-in-class Customer Experience, especially in communicating with members regarding benefits and contract limitations. The position is also responsible for the accuracy of gatekeeping controls through the correct application of benefits based on contract and guidelines.
Job Specifications
Minimum Education: Graduate of Doctor of Medicine
Licensure: PRC board certified
Certifications: Certified member of Medical organization (PAFP)
Experience Required: Minimum of 5 years of relevant work experience in the HMO industry in a managerial capacity.
Competencies
Core: Proficiency in HMO practices with extensive experience in the following areas:
- Utilization Management
- Customer Service
- Strategic planning and project management
- People development and team collaboration
- Negotiation, mediation, and conflict resolution techniques
Technical: Medical knowledge in healthcare operations
Universal: Knowledge of MS Office applications
#J-18808-Ljbffr-
Medical Content Specialist
6 days ago
Manila, National Capital Region, Philippines Inizio Medical Full timeMedical Content Specialist - Medical CommunicationsManila, PhilippinesWe are expanding our team of Medical Content Specialists based in the Philippines. Our Philippines team works alongside our global teams in ApotheCom, Nucleus Global and Ashfield MedComms across the US, UK, EU, and South Africa which will give you the opportunity to work on cutting edge...
-
Medical Staffing Coordinator
1 week ago
Manila, National Capital Region, Philippines Theoria Medical Full time**Job Overview:**We are seeking a highly organized and detail-oriented Medical Staffing Coordinator to join our team at Theoria Medical. As a key member of our human resources department, you will be responsible for assisting with various administrative tasks, including updating candidate databases, reporting, and communicating with recruitment teams.Salary:...
-
Human Resources Coordinator
1 week ago
Manila, National Capital Region, Philippines Theoria Medical Full timeCompany Overview">Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. Our mission is to provide high-quality healthcare services to our patients while promoting innovation and excellence in patient care.">Salary and Benefits">We...
-
Medical Credentials Professional
7 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeAbout the RoleThe Medical Credentials Professional will be responsible for supporting the Human Resources Department with staffing onboarding and offboarding. This includes maintaining accurate records, ensuring compliance with regulations, and communicating with healthcare administrators.We offer a competitive salary package and opportunities for growth and...
-
Human Resources Assistant
6 hours ago
Manila, National Capital Region, Philippines Theoria Medical Full timeJob SummaryThe Human Resources Department at Theoria Medical is seeking an experienced Recruitment Coordinator to support its expansion and assist with staffing onboarding and offboarding.The ideal candidate will have strong organizational skills, excellent communication abilities, and the ability to work independently in a fast-paced environment.
-
Medical Compliance Specialist
14 hours ago
Manila, National Capital Region, Philippines Theoria Medical Full timeAbout Theoria MedicalTheoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care. We offer a broad scope of services including multispecialty physician services, telemedicine, remote patient monitoring, and more.We currently operate...
-
Human Resources Coordinator
6 days ago
Manila, National Capital Region, Philippines Theoria Medical Full time**About Us**Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum. We offer a broad scope of services including multispecialty physician services, telemedicine, remote patient monitoring, and more.We currently operate primary care clinics and provide medical services to skilled nursing...
-
Medical HR Liaison Specialist
1 week ago
Manila, National Capital Region, Philippines Theoria Medical Full timeCompany OverviewTheoria Medical is a comprehensive medical group dedicated to serving patients across the care continuum. We provide multispecialty physician services, telemedicine, remote patient monitoring, and more. As a leading-edge, innovative, and quality-driven physician group, we continue to expand nationally.We are seeking an experienced Medical HR...
-
Human Resources Coordinator
4 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeAbout This RoleThis position plays a crucial role in supporting the growth of Theoria Medical's Human Resources Department. As a Compliance Operations Specialist, you will be responsible for managing various administrative tasks, ensuring seamless communication, and maintaining accurate records.ResponsibilitiesManage and Maintain Candidate Databases:...
-
Medical Client Services Director
4 days ago
Manila, National Capital Region, Philippines Global Medical Virtual Assistants Full timeAbout Us:As a leading provider of virtual assistance services, Global Medical Virtual Assistants offers a unique opportunity for experienced professionals to lead our team of virtual assistants. As a Virtual Assistant Team Lead, you will play a crucial role in ensuring the success of our clients by providing exceptional service and support.Your Role:You will...
-
Medical Director
2 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeCompensation: Up to $400,000 annually + monthly Medical Director StipendJob Location: In personJob HighlightsWork-Life Balance: Competitive compensation with balanced hours.Always Supported: NP/PA support at all locations, always.Pre-Screened Patient Interactions: Virtual care team and APP triage before physician contact.Flexible Scheduling: Your schedule,...
-
Human Resources Compliance Lead
4 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeTheoria Medical is a dynamic healthcare organization dedicated to providing exceptional patient care. Our Human Resources Department is seeking a skilled Compliance Lead to support our growth and expansion.Key Responsibilities:Manage candidate databases and update records as necessaryCoordinate with recruitment teams to track candidate progressEnsure timely...
-
Human Resources Analytics Expert
3 days ago
Manila, National Capital Region, Philippines Fresenius Medical Care Full timeAbout the RoleFresenius Medical Care is a leading provider of medical devices and services for patients with chronic kidney disease. We are currently seeking an experienced Human Resources Analytics Expert to join our team.Main Responsibilities:Develop and maintain workforce dashboards to support business decision-making.Analyze trends and leverage expertise...
-
Human Resources Administrator
1 week ago
Manila, National Capital Region, Philippines Theoria Medical Full timeJob DescriptionTheoria Medical seeks an experienced Human Resources Administrator - Recruitment to join our team. This role will involve updating candidate databases, communicating daily with Recruitment Liaison & Contracts Specialist, and drafting adobe emails for review and signature.Key ResponsibilitiesUpdating candidate databases on candidate...
-
Remote Medical Staffing Coordinator
6 hours ago
Manila, National Capital Region, Philippines Theoria Medical Full timeTheorya Medical is a leading provider of medical services and technology solutions. We are seeking a highly motivated and detail-oriented Credentialing Specialist to join our team.">Key Responsibilities:">Manage the credentialing process from initial application to final approvalEnsure accuracy and completeness of all credentialing documentsCommunicate...
-
Medical Recruiter
1 week ago
Manila, National Capital Region, Philippines Theoria Medical Full timeTheoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care.We are seeking a highly motivated healthcare recruiting professional to join our team as a Corporate Recruiter. As a leading edge, innovative, and quality driven physician group,...
-
Medical Technology Developer
7 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeTheoria Medical is a leading edge, innovative, and quality driven physician group, seeking a highly skilled Python Developer to join our Data Science and Analytics department.In this role, you will have the opportunity to work on exciting projects and contribute to the development of cutting-edge medical technology. Your primary responsibility will be to...
-
Manila, National Capital Region, Philippines Makati Medical Center Full timeJob SummaryThe Makati Medical Center is looking for a highly skilled Department Manager for Clinical Safety and Risk Management who can develop systems for identifying, collecting, analyzing, and monitoring safety-related information. This role requires strong collaboration with hospital leadership and other departments to identify, collect, analyze, and...
-
Medical Recruiter
3 days ago
Manila, National Capital Region, Philippines Theoria Medical Full timeTheoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute care and primary care.We offer a broad scope of services including multispecialty physician services, telemedicine, remote patient monitoring, and more. Our team is passionate about delivering quality...
-
Medical Content Specialist
6 days ago
Manila, National Capital Region, Philippines Inizio Medical Full timeMedical Content SpecialistWe are expanding our team of medical content specialists to work on cutting-edge projects in drug development and commercialization.Inizio Medical develops impactful medical affairs strategies and compelling communications. Our team works alongside global partners across the US, UK, EU, and South Africa.You will be responsible...