Healthcare Utilization Specialist

Job SummaryWe are seeking a skilled Healthcare Utilization Specialist to join our team at Selectcare Philippines Inc.Main Responsibilities:Conduct daily utilization rounds with coordination from Utilization Management Assistants for timely chart reviews;Determine medically appropriate and cost-effective provider settings when necessary;Develop quality...

Cobden & Carter International: A Leading Healthcare ProviderWe are seeking a skilled Healthcare Specialist to join our team in delivering exceptional patient care. As a key member of our team, you will be responsible for conducting initial admission and continued stay reviews utilizing InterQual and MCG to identify and support the appropriate level of...

We are looking for a seasoned professional to take on the role of Team Leader at Access Healthcare Services Manila, Inc. This individual will be responsible for overseeing the operations of our Pharmacy Utilization account and ensuring that our team delivers exceptional results.The ideal candidate will have a strong background in pharmacy utilization...

A career opportunity has arisen at Access Healthcare for a skilled Prior Authorization Specialist to join our team. In this role, you will be responsible for reviewing and processing prior authorization requests for medical procedures and treatments.Key Responsibilities:Review and process prior authorization requests from healthcare providers.Verify patient...

We are looking for a talented Utilization and Clinical Denials Nurse to join our clinical team at Access Healthcare Services Manila, Inc. This role involves reviewing medical cases, ensuring compliance with payer requirements, and assisting in the appeals process for denied claims. As a licensed nurse with at least one year of hospital experience, you will...

Job Summary: We are seeking a highly skilled Team Leader to join our team at Access Healthcare Services Manila, Inc. As a Team Leader, you will be responsible for overseeing the operations of our Pharmacy Utilization account and ensuring that our team delivers exceptional results.Key Responsibilities:Manage a team of professionals handling pharmacy...

We are looking for a highly skilled Utilization and Clinical Denials Nurse to join our clinical team at Access Healthcare Services Manila, Inc. As a licensed nurse with at least one year of hospital experience, you will be responsible for conducting thorough reviews of medical cases, analyzing denials, and assisting in the appeals process for denied...

Job Description: We are seeking a highly skilled Team Leader to join our team at Access Healthcare Services Manila, Inc. As a Team Leader, you will be responsible for overseeing the operations of our Pharmacy Utilization account and ensuring that our team delivers exceptional results.Responsibilities:Lead a team of professionals handling pharmacy utilization...

Are you a detail-oriented and analytical nurse looking for a challenging role? We are seeking a Utilization and Clinical Denials Nurse to join our clinical team at Access Healthcare Services Manila, Inc. In this role, you will conduct thorough reviews of medical cases, analyze denials, and assist in the appeals process for denied...

At Access Healthcare Services Manila, Inc., we are committed to delivering high-quality healthcare services to our patients.We are currently seeking a skilled Registered Nurse to assume a key role in our team.Job Summary:Perform advanced level work related to clinical denial and utilization management.Manage medical denials by reviewing clinical...

Job Description:At UST, we are seeking a skilled Clinical Utilization Manager to join our team. As a key member of our healthcare team, you will play a critical role in ensuring the highest quality patient care while promoting efficient resource utilization.We are looking for a registered nurse with current, unrestricted US licensure and at least 3 years of...

Job DescriptionWe are seeking a highly skilled Civil Engineer to join our team as a Public Utility Specialist. As a key member of our engineering department, you will be responsible for coordinating and producing drawings and drafting requirements for assigned projects.You will work closely with multidisciplinary consultants and internal teams to ensure...

Access Healthcare Services Manila, Inc. is a leading provider of healthcare solutions, seeking highly motivated and detail-oriented individuals to join our team as Prior Authorization Coordinators. This role is ideal for fresh graduates with a Medical Allied degree who possess excellent communication skills and are eager to build their careers in a BPO...

Job Summary:We are seeking a skilled Healthcare Financial Specialist to join our team at Tenet Global Business Center, Inc. In this role, you will be responsible for processing accounts and working with designated payors to ensure proper reimbursement.Key Responsibilities:Process claims accurately and efficiently, utilizing knowledge of billing compliance...

Access Healthcare Services Manila, Inc. is seeking a skilled Utilization and Clinical Denials Nurse to join our growing clinical team. As a licensed nurse with at least one year of hospital experience, you will play a crucial role in reviewing medical cases, ensuring compliance with payer requirements, and assisting in the appeals process for denied...

We are seeking a Healthcare Liaison Specialist to provide initial contact between distinct Care Management programs and specific identified members. This role involves providing technical support to various staff, ensuring that assigned staff are directed to the appropriate resources.Primary duties may include:Understanding and applying specific workflow,...

About This PositionWe seek a dedicated Clinical Appeals Coordinator to join our team at UST. As a key member, you will play a vital role in providing exceptional customer support, managing complex appeals and grievances, and ensuring high-quality outcomes.Your responsibilities will include investigating and processing appeals, reviewing services for medical...

Omega Healthcare Management Services Inc. is committed to excellence in patient care and operational efficiency. As a valued member of our team, you will have the opportunity to grow professionally and make a meaningful impact in the healthcare industry.RequirementsA minimum of 3 years of experience in bedside nursing, preferably in Med-Surg, ICU, or ED...

At MiraMed Philippines Group, we are seeking a skilled and detail-oriented individual to join our team as a Healthcare Spanish Language Support Specialist.The ideal candidate will have excellent communication skills in both English and Spanish, with the ability to understand and interpret medical terminology.Key Responsibilities:Provide accurate and timely...

Job SummaryThe Credentialing Specialist plays a crucial role in ensuring timely processing of credentialing activities. Collaborating with the team, this specialist verifies healthcare providers' qualifications and certifications, guaranteeing they meet regulatory standards and requirements.Responsibilities:Credential Verification: Ensure healthcare...