Manager Medical Management
7 days ago
Responsible to manage a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources. Primary duties may include, but are not limited to: Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective. Areas managed may include authorizing inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources. Applies clinical knowledge to work with facilities and providers for care-coordination. May also manage appeals for services denied. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Requires current active unrestricted RN license to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States, except in government business where it is preferred, and 5 years acute care clinical experience or any combination of education and experience, which would provide an equivalent background. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. The following are level distinctions not required for posting. This level typically reflects a new manager, one managing a singular function, a manager with a smaller span of management, or one located in a unit where a higher level of management exists.For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. This is an example of some common job content that can be shown at the bottom of every job description. It is added in the CMS and then shown on every job. It can be used to supplement the job content that comes from the ATS.
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Medical Case Manager
7 days ago
Taguig, Philippines Gratitude Philippines Full timeRoles And Responsibilities PH Registered nurses to review workers compensation claims with serious injury and that need surgery/lengthy treatments, create a return-to-work plan, work with various stakeholders (medical providers, injured worker, employer, attorney) to track the treatment plan and help bring the injured worker back to work. Nurses have...
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Assistant Sales Manager for Medical Devices
2 weeks ago
Philippines, Quezon City Delex Pharma International, Inc. Full timeCompany DescriptionDelex Pharma International, Inc. is the 3rd largest in the hospital channel and an ISO 9001:2015-certified Filipino-owned pharma and medical device company with topnotch global partners. The company aims to bring quality and cost-effective medicines and medical devices to the service of the Filipino people.Role DescriptionThis is a...
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Licensed Medical Technologist
5 days ago
Philippines, Central Visayas OPON MEDICAL DIAGNOSTIC CORP Full timeGraduate of BS Medical Technology with valid PRC License New Board passers are welcome to apply Can adapt quickly to changing conditions and technologies, be professional, meet the needs of a busy lab, and stay organized. Understanding of cell biology, human anatomy, virology, the symptoms of many diseases, and how to interpret data from tests and images...
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Medical Coder
7 days ago
Philippines, Quezon City RSD Human Resource Management Consultancy Full timeResearches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results.
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Medical Sales Representative
7 days ago
Philippines Business Innovations Gateway Inc. Full timeResponsibilities Promoting and selling company health products, specifically medications, to doctors, pharmacists, and other relevant healthcare professionals within Ethical Operations such as hospitals, doctors' clinics, etc. Scheduling appointments with doctors, pharmacists, and other healthcare professionals to present and promote company medications....
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Medical Devices Lead Auditor
7 days ago
Philippines SGS (Malaysia) Sdn Bhd Full timeJob DescriptionWe have an excellent new opportunity fora Medical Device Lead Auditor to join our global organization.The successful candidate will be responsible for planning and conducting audits against the manufacturing of medical devices, in accordance with ISO 13485, MDD 93/42/EEC, and MDSAP standards, enabling the delivery of assessment and...
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PHRN and Medical Allied Graduates
7 days ago
Philippines Nezda Technologies, Inc. Full timeNezda is currently hiring for PHRN and Medical Allied Graduates for Healthcare Account. Competitive Salary Package Location: Ortigas, Pasig & CebuQualifications: PHRN or medical allied graduate With Utilization management / review experience Prior Authorization experience: US Medical Billing Experience Can work onsite
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Purchasing Secretary for Medical Supplies
2 weeks ago
Philippines RemoteVA Full timeWe are looking for a detail-oriented and organized Secretary to manage the procurement of medical supplies and handle accounts payable using QuickBooks Desktop. The primary responsibility of this role will be purchasing medical supplies, requiring prior experience in medical supplies procurement. Additionally, the successful candidate will be responsible for...
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Nurse Medical Mgmt I
2 weeks ago
Philippines Carelon Global Solutions Full timeDescription: Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources. Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and...
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Medical Coder NA2024
7 days ago
Philippines, Quezon City RSD Human Resource Management Consultancy Full timeAnalyzes medical records and identifies documentation deficiencies.Serves as resource and subject matter expert to other coding staff.Reviews and verifies documentation supports diagnoses, procedures and treatment results.Qualification Hard Coding Experiences Certified Professional Coder (Required)
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Sales and Medical Liaison
7 days ago
Philippines Polytechnic University of the Philippines Full timeDescription:The Sales & Medical Liaison (SML) position is a field based job. Its role is to focus on developing and maintaining the company vital links to our targeted healthcare professionals, providers and patient segments.Duties and Responsibilities:-Represent and establish the company rapport with our targeted healthcare professionals, providers and...
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In/Out Patient Medical Coder
7 days ago
Philippines, Quezon City RSD Human Resource Management Consultancy Full timeesearches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures and treatment results.
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Medical Coder
7 days ago
Philippines HCM Nexus Consulting Inc Full timeAbout the job Medical CoderJOB SUMMARYUnder the general supervision of the Operations Manager, the Coder assigns diagnosis and procedurecodes to patient medical records and enters coding and abstracting patient data into the facilitycomputer system. Generally, performs coding on all types of cases. Position can be specialized tocode inpatient, outpatient, or...
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Labor Relations Specialist
7 days ago
Philippines The Medical City Full timeAt The medical City, we bridge the gap between Filipinos and health services. An ambitious mission, and to achieve it we need the bright minds of our countryâs young leaders. Young leaders who are willing to inspire a generation and take on the challenges we are faced today. The Medical City seeks to be the home of the worldâs best when it comes to...
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Medical Transcriptionist
7 days ago
Philippines, San Miguel Polytechnic University of the Philippines Full timeDescription:Duties and Responsibilities:MTs responsibility include typing and proofinng medical reports dictated by physicians.The MT tranees' responsibilities include going to training without any absences or tardiness during the duration of training and must be willing to take the TESDA NC-ll national assessment for medical...
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Medical Representatives
7 days ago
Philippines HCM Nexus Consulting Inc Full timeAbout the job Medical RepresentativesWe are seeking a dynamic and results-oriented Medical Sales Representative to join our team. Your primary responsibility will be to develop and implement effective business sales plans tailored to individual customers, specifically targeting Healthcare Practitioners (HCPs). This role is crucial in driving business growth...
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HR Operations Manager
7 days ago
Philippines Fresenius Medical Care Full timeThe HR Operations Manager is responsible for leading Human Resources processes and programs such as performance management, compensation, recruitment, workforce planning, and employee development. Assists managers in planning, implementing, and evaluating Human Resources initiatives.TasksManage the tactical execution of short and long-term objectives through...
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Treasury Officer
7 days ago
Philippines The Medical City Full timeAt The medical City, we bridge the gap between Filipinos and health services. An ambitious mission, and to achieve it we need the bright minds of our country's young leaders. Young leaders who are willing to inspire a generation and take on the challenges we are faced today. The Medical City seeks to be the home of the world's best when it comes to...
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District Sales Manager
7 days ago
Philippines Polytechnic University of the Philippines Full timeDescription:. Recruit, develop and maintain at all times a successful team of 6-7 medical salesrepresentatives.. Deliver 100% of the monthly and periodic assigned team sales objectives.. Train, coach and motivate team members to perform effectively the day-to-day tasks andresponsibilities within the corporate guidelines.Duties and Responsibilities:. In...
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Medical Representative for Diab
2 weeks ago
Philippines Asia Select Inc. Full timeJob DescriptionJob Description:Be part of a leading multinational pharmaceutical company in the country as a Medical Representativewho has a vital role in promoting and selling pharmaceutical products to healthcare professionals and institutions. This position involves building strong relationships with healthcare professionals, disseminating accurate...