Clinical Utilization Specialist

Job Title: Clinical Utilization SpecialistGratitude Philippines is seeking a highly skilled Clinical Utilization Specialist to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the highest quality of care for our patients.Key Responsibilities:Conduct thorough reviews of patient cases to ensure medical necessity and...

Job Title: Clinical Utilization Review SpecialistAbout the Role:Gratitude Philippines is seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our Utilization Review team, you will be responsible for reviewing treatment authorization requests based on state guidelines and medical necessity.Key...

Job Title: Utilization ReviewerJob Summary: We are seeking a highly skilled Utilization Reviewer to join our team at Gratitude Philippines. As a Utilization Reviewer, you will be responsible for reviewing medical records and ensuring that patients receive the necessary treatments and care. Our ideal candidate will have a Bachelor's degree in nursing, 1-2...

Job Title: Utilization ReviewerGratitude Philippines is seeking a skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that patients receive appropriate and necessary medical care while minimizing costs.Key Responsibilities:Review treatment authorization requests based on state guidelines and...

Role Summary: We are seeking a skilled RN Clinical Specialist to join our team at Gratitude Philippines. In this role, you will be responsible for handling clinical appeals and denials for healthcare insurance claims.Key Responsibilities:Review and evaluate clinical appeals and denials for healthcare insurance claimsUtilize clinical expertise to make...

Job SummaryMetaHealth is seeking a skilled Clinical Support Specialist to join our team. As a Clinical Support Specialist, you will be responsible for providing top-notch support to our clients. Your analytical skills will be utilized to troubleshoot and resolve issues, ensuring a positive impact on client satisfaction.ResponsibilitiesProvide clinical...

Job SummaryWe are seeking an experienced Advanced Clinical Nurse Specialist to join our team at Gratitude Philippines. In this role, you will utilize your expertise in utilization management review and clinical appeals and denials handling for healthcare insurance/ UMRS.About the RoleThis is a full-time position that requires flexible shifts, with a...

Job Title: Clinical Coding SpecialistAbout the Role:We are seeking a skilled Clinical Coding Specialist to join our team at TASQ Staffing Solutions.Key Responsibilities:The successful candidate will be responsible for performing accurate and timely coding of patient records, ensuring compliance with industry standards and regulations.Requirements:To be...

We are seeking a skilled Clinical Care Specialist to join our team at Megaworld Corporation. This is a Full-time position that requires a Registered Nurse with a strong background in patient care and clinical skills.The ideal candidate will have at least 1 year of experience in nursing and be proficient in MS Office. The following skills are...

Job Title: Clinical Excellence SpecialistJob Summary:We are seeking a Clinical Excellence Specialist to join our team at Gratitude Philippines. The successful candidate will be responsible for carrying out quality assurance oversight activities, conducting regular reviews of managed care internal and external claim files, and analyzing quality assurance...

Job Title: Clinical Nurse Specialist - Accidental ClaimsAbout the Role: We are seeking a highly skilled Clinical Nurse Specialist to join our team at TASQ Staffing Solutions. As a key member of our staff, you will be responsible for handling accidental claims with exceptional attention to detail and organizational skills.Job Responsibilities: Your primary...

OverviewThe Manpower Core Group Inc. seeks a skilled Clinical Telephonic Nurse Specialist to provide exceptional patient care and support via telephone assessments, health advice, and referrals.Key Responsibilities:Performing intake of phone calls from injured employees to provide timely and effective assistance.Conducting telephonic health assessments,...

Tasq Staffing Solutions is hiring a Inpatient Medical Coder to join our team. This role is perfect for individuals with experience in clinical, BPO, or CPO set-ups who are passionate about medical coding and have excellent communication skills.The ideal candidate will possess a Bachelor's degree in Nursing or a related field and be certified as a Certified...

Job SummaryThe Clinical Review Nurse position is a critical role in assessing the medical appropriateness of proposed treatments and medications for our injured employees. This position partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim, while maintaining a solid understanding of the Client's mission,...

Job Title: BPO Utilization ReviewerSummary:The Clinical Review Nurse position is responsible for assessing the medical appropriateness of proposed treatments and medications for our injured employees. This role partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim, while maintaining a solid understanding of...

Job Title: Telephonic NurseJob Summary:We are seeking a skilled Telephonic Nurse to join our team at Manpower Core Group Inc. The successful candidate will be responsible for providing safe and effective telephone assessments, patient care instructions, and directions to the appropriate level of care.Key Responsibilities:Perform intake of phone calls from...

Job SummaryAs a key member of our team at Holistic Approach Systems Inc., the Area Personnel/ Utility professional plays a vital role in ensuring the smooth operation of our facilities. This role is responsible for providing support in various areas, including ground maintenance, kitchen, and production areas.Key ResponsibilitiesAssist in maintaining the...

Job Title: Quality Assurance SpecialistGratitude Philippines is seeking a highly skilled Quality Assurance Specialist to join our team. As a Quality Assurance Specialist, you will play a critical role in ensuring the quality of our healthcare services.Responsibilities:Conduct regular and systematic reviews of managed care internal and external claim files to...

Job Title: Trainer - Medical Education SpecialistGratitude Philippines is seeking a highly skilled Trainer - Medical Education Specialist to join our team. As a key member of our corporate development and training team, you will be responsible for designing, implementing, and evaluating comprehensive education programs to meet the ongoing competency needs...

Job Title: PHRN OHNJob Summary:We are seeking a highly skilled and motivated PHRN OHN to join our team at MetaHealth. As a key member of our healthcare team, you will be responsible for providing top-notch support to our clients.Key Responsibilities:Use your analytical skills to troubleshoot and resolve issuesMake a positive impact on client...