Clinical Utilization Specialist
2 days ago
Gratitude 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 appropriateness of treatment
- Collaborate with healthcare providers to develop and implement effective treatment plans
- Stay up-to-date with the latest medical research and guidelines to ensure evidence-based decision-making
- Communicate effectively with patients, families, and healthcare teams to ensure seamless care coordination
- Bachelor's degree in nursing (BSN)
- Active unrestricted RN license
- 1-2 years of relevant clinical experience in medical/surgical departments, ICU, or rehabilitation
- Excellent written and verbal communication skills in English
- Ability to work onsite in BGC and adhere to US operation hours
- Proficiency in Microsoft Office products, including Project, Word, Excel, PowerPoint, Visio, and SharePoint
- Knowledge of workers' compensation laws and regulations, behavioral health, case management practice, URAC standards, ODG, and utilization review
- Leadership and management skills, as well as analytical and organizational abilities
As a Clinical Utilization Specialist at Gratitude Philippines, you will have the opportunity to make a meaningful impact on the lives of our patients and their families. If you are a motivated and compassionate healthcare professional looking for a challenging and rewarding role, we encourage you to apply.
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Clinical Utilization Review Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob Title: Clinical Utilization Review SpecialistGratitude Philippines is seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our healthcare team, you will play a critical role in ensuring that our clients receive the most appropriate and cost-effective care.Key Responsibilities:Review treatment authorization...
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Clinical Utilization Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob Title: Utilization ReviewerGratitude Philippines is seeking a highly skilled Utilization Reviewer to join our team.Key Responsibilities:Conduct thorough reviews of medical records to ensure compliance with workers' compensation laws and regulations.Utilize strong analytical and organizational skills to identify areas for improvement in healthcare...
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Clinical Utilization Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob Title: Utilization ReviewerGratitude Philippines is seeking a highly skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will play a critical role in ensuring that our healthcare services are delivered efficiently and effectively.Key Responsibilities:Conduct thorough reviews of medical records to ensure that healthcare services...
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Clinical Utilization Review Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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...
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Clinical Appeals Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeClinical Opportunities at Gratitude Philippines**Job Summary**We are seeking a skilled Clinical Appeals Specialist to join our team. The ideal candidate will have a strong background in utilization management review or clinical appeals and denials handling for healthcare insurance/UMR.**Key Responsibilities**- Conduct thorough reviews of medical claims to...
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Clinical Appeals Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob Title: Clinical Appeals SpecialistWe are seeking a highly skilled Clinical Appeals Specialist to join our team at Gratitude Philippines.Key Responsibilities:Review and analyze medical claims to ensure accurate processing and reimbursement.Communicate with healthcare providers and patients to resolve billing discrepancies.Develop and implement strategies...
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Clinical Support Specialist
3 days ago
Taguig, National Capital Region, Philippines MetaHealth Full timeJob SummaryWe are seeking a highly skilled Clinical Support Specialist to join our team at MetaHealth. As a key member of our healthcare team, you will play a vital role in ensuring the highest level of patient care and satisfaction.ResponsibilitiesProvide top-notch support to clients, ensuring their needs are met and exceeded.Utilize your analytical skills...
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Clinical Review Nurse
3 days ago
Taguig, National Capital Region, Philippines Manpower Core Group Inc. Full timeJob Title: Clinical Review NurseAt Manpower Core Group Inc., we are seeking a highly skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in assessing the medical appropriateness of proposed treatments and medications for our injured employees.Key Responsibilities:Review treatment authorization requests...
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Clinical Implementation Manager
1 month ago
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Clinical Review Nurse
3 days ago
Taguig, National Capital Region, Philippines Manpower Core Group Inc. Full timeJob 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,...
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Quality Assurance Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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.Key Responsibilities:Conduct regular reviews of managed care internal and external claim files to validate...
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Quality Assurance Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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...
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Medical Education Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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 organization, you will be responsible for developing and implementing comprehensive education programs to meet the needs of our medical professionals.Key Responsibilities:Design and...
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Medical Education Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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 organization, you will be responsible for developing and implementing comprehensive education programs to meet the needs of our medical professionals.Responsibilities:Design and...
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Quality Assurance Specialist
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob SummaryGratitude 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. Your primary responsibility will be to conduct quality assurance oversight activities, including regular and systematic reviews of...
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Utility Specialist
2 days ago
Taguig, National Capital Region, Philippines Holistic Approach Systems Inc. Full timeJob 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...
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Medical Education Specialist Trainer
3 days ago
Taguig, National Capital Region, Philippines Gratitude Philippines Full timeJob 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...
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Healthcare Support Specialist
3 days ago
Taguig, National Capital Region, Philippines Recruiting Company Full timeJob Title: Patient Care Specialist Job Summary: We are seeking a highly skilled and compassionate Patient Care Specialist to join our team at Recruiting Company. As a Patient Care Specialist, you will play a vital role in ensuring the delivery of exceptional patient care and services in our clinic. Responsibilities: * Provide top-notch patient care and...
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Clinical Support Specialist
3 days ago
Taguig, National Capital Region, Philippines MetaHealth Full timeJob 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...
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Clinical Support Specialist
3 days ago
Taguig, National Capital Region, Philippines MetaHealth Full timeJob Title: PHRN OHNJob Summary:We are seeking a highly skilled and detail-oriented PHRN OHN to join our team at MetaHealth. As a key member of our healthcare operations team, you will be responsible for providing top-notch support to our clients.Responsibilities:Use your analytical skills to troubleshoot and resolve issues in a timely and efficient...