Patient Care Coordinator

20 hours ago


Las Piñas, National Capital Region, Philippines beBeeNursing Full time ₱50,000 - ₱68,000
Career Opportunity

As a Clinical Nurse Case Manager, you will play a vital role in coordinating patient care and ensuring optimal health outcomes.

About the Role

This position involves conducting comprehensive reviews of patient services to ensure medically necessary and quality healthcare is delivered in a cost-effective manner.

Responsibilities
  • Conduct thorough assessments of patient service requests to ensure compliance with applicable criteria, medical policy, member eligibility, benefits, and contracts.
  • Utilize client-specific criteria sets (e.g., Milliman or InterQual) to approve or summarize services for review by clients' nursing reviewers or medical staff.
  • Collaborate with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.
Skills and Qualifications

To be successful in this role, you will need:

  • Excellent critical thinking and problem-solving skills
  • Strong communication and interpersonal skills
  • Able to work effectively in a team environment
  • Familiarity with client-specific criteria sets and medical policies
Benefits

We offer a competitive salary, comprehensive benefits package, and opportunities for professional growth and development.

Why Join Us?

This is an exciting opportunity to join our team and make a meaningful difference in the lives of our patients.



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