Utilization Review Expert

We are looking for a seasoned Utilization Review and Improvement Expert to join our team at Gratitude Philippines. This role demands a high level of proficiency in analyzing and managing complex cases, leveraging extensive knowledge of medical procedures, regulatory compliance, and best practices in healthcare.The successful candidate will bring a unique...

Utilization Reviewer Job Description:We are seeking a highly skilled Utilization Reviewer to join our team at Gratitude Philippines. As a Utilization Reviewer, you will play a critical role in reviewing medical treatments to ensure that they are necessary and delivered effectively. Your expertise in utilization review will enable you to identify potential...

Roles and Responsibilities:• PH Nurses to review treatment authorization request based on state guidelines and medical necessity and take decision to approve/deny. In case of denial send this to independent panel review to support the decision. Nurses will work with Claims adjuster on denial decision based on risk tolerance to ensure the denial doesn't...

Required Qualifications:• Bachelor's degree in nursing (BSN)• Active unrestricted RN license that can be validated thru PRC website• 1-2 years of relevant Clinical experience in any medical/surgical department, Orthopedic, Medical/Surgical ICU, Coronary Care Unit (CCU), Rehabilitation, Emergency department• Written and verbal fluency in English•...

Summary:The Clinical Review Nurse position assesses the medical appropriateness of proposed treatments and medications for our injured employees, and partners with the Client Claims Adjuster team to expedite medically necessary treatment for each claim. Maintains a solid understanding of Client's mission, vision, and values. Upholds the standards of the...

Job SummaryWe are seeking a skilled Clinical Utilization Manager to join our team.

Job Description:The Clinical Utilization Review Specialist is a critical role at Gratitude Philippines, responsible for ensuring that medical treatments are necessary and delivered effectively. As a key member of our team, you will work closely with claims adjusters to review treatment authorization requests based on state guidelines and medical...

Job DescriptionNeksjob Philippines is seeking a skilled Utilities S/4HANA PM expert to join our team. As a key member of our utilities sector practice, you will work closely with clients to design and implement custom solutions for their maintenance and asset management needs.Responsibilities include:Collaborating with business stakeholders to identify...

About Our TeamWe are a team of experts in the utilities sector, dedicated to delivering high-quality solutions for our clients. As a key member of our team, you will work closely with business stakeholders to understand their maintenance workflows and asset management needs.Responsibilities include:Collaborating with business stakeholders to design and...

The Oracle Utilities Products Consultant is responsible for delivering expert consulting services for Oracle Utilities products and solutions. This role involves working closely with clients to implement, optimize, and support Oracle Utilities software, ensuring that these solutions meet business requirements and drive operational efficiency. The consultant...

The Oracle Utilities Products Consultant is responsible for delivering expert consulting services for Oracle Utilities products and solutions. This role involves working closely with clients to implement, optimize, and support Oracle Utilities software, ensuring that these solutions meet business requirements and drive operational efficiency. The consultant...

Job DescriptionWe are seeking a highly skilled RN Case Management Professional to join our team at Gratitude Philippines. As a key member of our healthcare team, you will be responsible for managing the care of patients with complex medical conditions.The ideal candidate will have 5+ years of experience in utilization management review or clinical appeals...

Job SummaryThe Clinical Review Specialist position is responsible for assessing the medical appropriateness of proposed treatments and medications for injured employees. This role requires a strong understanding of client mission, vision, and values.Key Responsibilities:Review treatment authorization requests based on state guidelines and medical...

**About the Role**We are seeking a highly skilled Oracle Utilities Functional Architect to join our team at JobsAvenuePH. As a key member of our Global Professional Services Firm, you will play a crucial role in delivering high-quality solutions to our clients.Key Responsibilities:Conduct and attend workshops with clients to understand business requirements...

The Oracle Utilities Products Consultant is responsible for delivering expert consulting services for Oracle Utilities products and solutions. This role involves working closely with clients to implement, optimize, and support Oracle Utilities software, ensuring that these solutions meet business requirements and drive operational efficiency. The consultant...

The Oracle Utilities Products Consultant is responsible for delivering expert consulting services for Oracle Utilities products and solutions. This role involves working closely with clients to implement, optimize, and support Oracle Utilities software, ensuring that these solutions meet business requirements and drive operational efficiency. The consultant...

Utilities - SAP ISU ConsultantFind endless opportunities to solve challenging problems, as you work with exceptional professionals, cutting-edge technology, and leading companies across industries.Practice: Utilities | Areas of Work: SAP ISU FICA | Level: 9 Location: Global | Years of Experience: 4-12 yearsExplore an Exciting Career OpportunityIf you want to...

Utilities - SAP ISU ConsultantFind endless opportunities to solve challenging problems, as you work with exceptional professionals, cutting-edge technology, and leading companies across industries.Practice: Utilities | Areas of Work: SAP ISU FICA | Level: 9Location: Global | Years of Experience: 4-12 yearsExplore an Exciting Career OpportunityIf you want to...

Oracle Utilities Functional ArchitectJob DescriptionConduct and attend workshops with the client for a specific/multiple workstreams.Understand business requirements and/or high-level designs from clients/stakeholders and provide high-level estimates.Manage and monitor projects to ensure that delivery schedule is on target, defined milestones are met,...

Job SummaryWe are looking for an experienced Expert Radiologist to join our team at Lifetrack Medical Systems. In this role, you will be responsible for providing expert consultation and image interpretation to a network of healthcare facilities via a sophisticated teleradiology network.You will also provide mentoring and training to new members, ensuring...