Healthcare Provider Role

1 day ago

Quezon City, National Capital Region, Philippines beBeeHealthcare Full time ₱35,000 - ₱70,000
Job Description:

Clinical Instructors in this role are responsible for providing Day-to-Day Functional Direction of Learners within the Training Environment, including monitoring progress and providing coaching and developmental feedback. They prepare and present training materials through classroom learning, hands-on demonstrations, and supporting activities. Additionally, they support and partner with delivery teams to transition learners from training to production environments.

Furthermore, Clinical Instructors investigate and resolve member grievances related to Medicare Part D drug coverage, medical claims, and pharmacy issues. They ensure all member grievances are resolved within the required CMS timeline and documented appropriately.

Acting as liaisons between members, medical and healthcare providers, and pharmacies, Clinical Instructors provide clear and empathetic communication throughout the grievance process and transactions.

They adhere to all CMS guidelines and company policies, maintaining confidentiality of sensitive member information. Clinical Instructors accurately document all interactions and resolutions in the system, preparing reports for compliance and audit purposes.

Required Skills and Qualifications:
  • Bachelor's Degree in Nursing or a Pharmacy-related Field is Preferred, or relevant experience in a pharmacy-related role - 1 Year's Experience as a Pharmacy Technician (Drug Safety Review or Pharmacovigilance)
  • Experience as a Product Trainer (Learning Specialist) in a Similar Support Environment - Other related roles exposed to similar functions are also considered
  • Contact Center Experience is an Advantage (Similar Job Function); Licenses or Certifications are Not Required
  • Understanding of HIPAA and other Related Healthcare Regulations, knowledge of pharmacy operations, familiar with CRM tools and relevant healthcare platforms, proficiency in Microsoft Office Suite (Microsoft Word, Microsoft Excel, and Microsoft Outlook)
  • Willingness to Work On-Site with Flexible Work Schedules Including US Hours and Holidays
Benefits:
  • Interact/Collaborate and Learn from Industry Experts
  • Multiple Opportunities for Learning and Development
  • Enjoy a Fun and Competitive Working Environment
Job Details:
  • Seniority Level: Associate
  • Employment Type: Full-time
  • Job Function: Health Care Provider
  • Industries: Outsourcing and Offshoring Consulting

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