Healthcare Clinical Operations Specialist

7 days ago

Dasmariñas, Calabarzon, Philippines beBeeClinical Full time $22,000 - $22,150

Job Overview

Our organization seeks a detail-oriented individual to fill the role of Peer Review Specialist. The selected candidate will be responsible for conducting peer reviews, case consultations, and interacting with insurance payers in order to ensure seamless care delivery.

Main Responsibilities
  • Conduct thorough peer reviews and clinical case consultations to facilitate high-quality patient care.
  • Carefully review client charts prior to peer reviews to ensure comprehensive understanding.
  • Collaborate closely with the clinical team to gather updated information and address any concerns.
  • Maintain up-to-date knowledge of insurance medical necessity criteria to provide accurate support.
  • Document all authorization interactions within the electronic medical record system.
  • Participate actively in interdisciplinary team meetings to foster open communication and collaboration.
Required Qualifications
  • Current licensure as a Registered Nurse (RN).
  • Nurse Practitioner (NP), Medical Doctor (MD/DO), or Licensed Therapist (LCSW, LPC, LMFT, PsyD, PhD) preferred for optimal alignment with organizational goals.
  • A minimum of 2 years experience in behavioral health or psychiatric care is required to ensure effective performance in this role.

  • Clinical Process Specialist

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeCaregiver Full time ₱384,000 - ₱428,000

    Job Role OverviewClinical process specialists play a crucial role in ensuring the delivery of quality patient care. In this capacity, you will be responsible for reviewing patients' medical charts and determining the appropriate course of action.ResponsibilitiesThe ideal candidate will possess strong analytical skills, with the ability to review complex...

  • Clinical Reviewer

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeSkillful Full time ₱1,000,000 - ₱1,500,000

    Healthcare Specialist RoleWe are seeking a skilled professional to conduct clinical reviews of cases, perform clinical intake and adjudicate or request additional information.This is a temporary work-from-home position requiring a strong background in healthcare or medical domain. You should possess excellent communication skills, including verbal and...

  • Healthcare Content Specialist

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeMedical Full time ₱900,000 - ₱1,200,000

    Job TitleA medical content specialist is required to analyze, gather, and document clinical requirements using best practices defined by Clinical management. This role involves collaborating with subject matter experts to guarantee correct coding guideline interpretations.This position requires a strong analytical mind, effective communication skills, and...

  • Clinical Operations Representative

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeCareSpecialist Full time ₱4,800,000 - ₱6,300,000

    Job OverviewThe Care Account Specialist plays a pivotal role as the key clinical operations representative for enterprise clients in assigned regions. This position bridges client expectations with internal clinical standards and operational excellence.

  • Clinical Site Activation Specialist

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeOutreach Full time ₱7,200 - ₱7,800

    Senior Clinical Outreach ManagerWe are seeking a Senior Clinical Outreach Manager to join our team. As a key member of our organization, you will be responsible for designing and executing doctor outreach campaigns for clinical trial site activation.You will research and filter doctors using various tools such as ChatGPT, Google, NPI Registry, Definitive,...

  • Clinical Operations Manager

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeClinical Full time ₱7,000,000 - ₱9,000,000

    Job DescriptionThe role of the Care Account Specialist is a critical position that bridges enterprise client expectations with internal clinical standards and operational excellence. As the key clinical operations representative, you will act as the main point of contact for assigned enterprise clients, ensuring exceptional delivery of clinical services...

  • Clinical Outreach Lead

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeOutreach Full time ₱2,000,000 - ₱3,000,000

    Outreach SpecialistRDI is a clinical research company focused on diagnostics trials. We are looking for an experienced systems operator to lead our site outreach campaigns.This high-trust role offers autonomy and real impact, making it perfect for someone with strong communication skills and a passion for process improvement.Your Key Responsibilities:Design...

  • Senior Clinical Data Specialist

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeHealthcare Full time $21,600

    Job Title: Healthcare Analyst Role SummaryWe are seeking a detail-oriented and analytical Healthcare Analyst to support clinical and coding operations through accurate data analysis, involving Hierarchical Condition Categories (HCC), Risk Adjustment Factor (RAF) scoring, and healthcare claims review.

  • Healthcare Recruitment Specialist

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeHealthcare Full time $100,000 - $120,000

    Job Title: Healthcare Recruitment SpecialistAt our organization, we are seeking a skilled and experienced Healthcare Recruitment Specialist to join our team.Key Responsibilities:Sourcing and screening of international healthcare professionals including nurses, allied health professionals, and other healthcare workers.Conducting initial interviews and...

  • Clinical Research Development Opportunity

    7 days ago

    Dasmariñas, Calabarzon, Philippines beBeeClinicalResearch Full time ₱3,500,000 - ₱5,000,000

    Remote Clinical Research Development SpecialistWe are seeking a skilled Business Development professional with experience in clinical research to join our team as a Remote Clinical Research Development Specialist.The ideal candidate will have a passion for healthcare and sales, with strong communication and negotiation skills. They will be responsible for...