Utilization Management Program Senior Assistant Manager

7 days ago

Makati City, National Capital Region, Philippines Asalus Corporation (IntelliCare) Full time ₱1,500,000 - ₱2,500,000 per year

Duties & Responsibilities

Demonstrably optimize healthcare utilization for enrolled clients, achieving cost savings and improved member health outcomes through a robust Utilization Management Program.

  • Develop and Implement Client-Specific Utilization Management Strategies

  • Enhance Prior Authorization and Concurrent Review Processes

  • Strengthen Case Management and Disease Management Programs

  • Implement High-Cost Claimant Management

Continuously refine and implement innovative Utilization Management initiatives to ensure program effectiveness and client alignment.

  • Research and Pilot New UM Technologies and Methodologies
  • Conduct Regular Program Effectiveness Reviews
  • Tailor Utilization Management Programs to Evolving Client Needs and Market Trends
  • Integrate Behavioral Health and Physical Health Utilization Management

Foster collaborative partnerships with stakeholders and ensure transparent communication to maximize UM program adoption and success.

  • Establish Strong Internal Collaboration Channels
  • Develop and Maintain Provider Relationships
  • Enhance Client Communication and Reporting
  • Promote Member Engagement in Utilization Management Programs

Proactively monitor and evaluate Utilization Management program performance, driving continuous improvement through data-driven insights and feedback.

  • Develop Robust Data Analytics and Reporting Frameworks
  • Conduct Regular Performance Reviews and Deep Dives
  • Implement a Continuous Improvement Cycle
  • Benchmark Against Industry Standards and Competitors

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