Care Coordination Specialist

2 days ago


Mandaluyong City, National Capital Region, Philippines beBeeCare Full time ₱50,000 - ₱68,000

Job Title: Care Coordination Specialist

We are seeking a skilled and dedicated individual to fill the role of Care Coordination Specialist. In this position, you will play a crucial part in ensuring our members receive high-quality, cost-effective care.

Key Responsibilities:
  • Conduct Clinical Reviews: Utilize client-specific criteria sets, medical policy, and clinical guidelines to review service requests and make informed decisions about treatment appropriateness.
  • Ensure Member Access: Facilitate access to medically necessary healthcare services while maintaining cost-effectiveness according to contract agreements.
  • Collaborate with Stakeholders: Work closely with clinical reviewers and U.S.-licensed medical directors to ensure high-quality, cost-effective care throughout the medical management process.
  • Review Clinical Information: Conduct thorough reviews of clinical information against client-specific criteria for decision-making purposes.

Required Qualifications:
Clinical Experience: At least 1 year of experience in clinical or hospital settings.
Licensure: Active and non-active USRN license.
Educational Background: Relevant nursing education and training.

Benefits: This is a direct employment opportunity with no bond, offering flexible work arrangements and opportunities for professional growth.

About Us: We offer a supportive work environment that values collaboration and teamwork. If you are a motivated and compassionate individual who is passionate about delivering high-quality patient care, we encourage you to apply for this exciting opportunity.


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