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Medical Case Manager Coordinator

1 week ago

Manila, National Capital Region, Philippines Selectcare Philippines Inc Full time
About the Role

Selectcare Philippines Inc is hiring a Medical Case Manager Coordinator to oversee the coordination of patient care services.

Main Responsibilities:
  • The ideal candidate will perform daily case management duties, ensuring efficient and effective care delivery;
  • Collaborate with healthcare providers to determine the most suitable care settings and develop strategies for improved patient outcomes;
  • Assist in the development of quality improvement initiatives to enhance response times for pre-certification requests;
  • Support inpatient discharge operations and process necessary payments when required;
  • Apply clinical coding expertise in ICD and CPT coding systems;
  • Oversee hospital stay monitoring and coordinate discharges or alternative care plans;
  • Work closely with attending physicians to adjust the level of care as necessary, promoting optimal patient care;
  • Ensure timely concurrent reporting on all inpatient cases;
  • Analyze medical claims/cases to identify trends and recommend cost-effective care alternatives;
  • Generate reports and present findings to the UR Manager;
  • Acquire knowledge of querying medical data to identify high utilizers, frequent visitors, multiple hospitalizations, and medication users.