Appeals Operations Manager

Operations Manager – Clinical Appeals (PHRN)Bridgetowne, Quezon City | OnsiteNight Shift₱120,000 – ₱150,000Start Date: ASAP / Dec 31, 2025About the RoleWe are looking for an experienced Operations Manager for Clinical Appeals (PHRN) to lead and oversee appeals operations, ensuring compliance with medical necessity review standards, regulatory...

Job Title: PHRN – Appeals & Denials NurseWork Setup:On-site, Bridgetowne, Quezon CityShift:Night ShiftSalary Package:PHP 50,762 (Basic: 43,762 + 7,000 Allowance)Signing Bonus:Released on first payout for candidates who can join onDecember 9or immediatelyTarget Start Date:December 9, 2025Headcount:12Role SummaryThe PHRN Appeals & Denials Nurse is...

The Operations Manager for Utilization Management is responsible for managing and overseeing UM operations, ensuring compliance with industry standards and regulatory requirements. The role involves close collaboration with various stakeholders to drive performance and maintain high-quality standards.Key Responsibilities:Oversee daily operations and ensure...

Job Title: Operations Manager for Utilization Management - USRNShift: Night shiftWork Set-up: On-site in Bridgetowne, Quezon CitySalary range: 150K to 180KStart date: Dec 31, 2025/ ASAPLOB DESCRIPTION: Utilization Management - medical necessity approval/ denials for pre-service, retrospective, and concurrent services.JOB SUMMARY:The Operations Manager for...

Job Title:Operations Manager for Utilization Management – USRNWork Setup:On-site (Bridgetowne, Quezon City)Shift:Night ShiftSalary Range:₱150,000–₱180,000Description:Utilization Management (UM):Handles medical necessity reviews for pre-service, concurrent, and retrospective cases, including approval and denial decision-making.Job Description:The...

Job Summary:The Manager Operations is responsible for coaching and supervising a group of Team Leaders. This position is also responsible for ensuring Client Service Level Agreement and financial expectations are achieved.Essential Duties and Responsibilities:• Analyze and maintain all Client Service Level Agreements; implement improvement plans as...

Role Title: USRN/PHRN Operations ManagerECLARO: A quick SummaryECLARO is an award-winning professional services firm headquartered in New York City and operating in the U.S., Canada, UK, Ireland, Australia and the Philippines. We are dedicated to a singular purpose: providing the Right People to meet every client's needs and solve business challenges through...

The Operations & Leasing Associate Manager is responsible for supporting the efficient daily operations of the mall and ensuring tenant satisfaction, while also driving leasing activities to maximize occupancy, rental revenues, and the overall tenant mix. This role bridges operational excellence with strategic leasing, ensuring that the mall delivers a...

SUMMARYThe Claims Manager oversees the claims process, ensuring timely, accurate, and compliant review of claims.ESSENTIAL DUTIES AND RESPONSIBILITIESEnsures compliance with state and federal laws and regulations for Managed Care and other third party payorsMaintains a thorough understanding of Managed Care concepts including HMO, PPO, POS, EPO and...

Looking to level up your healthcare BPO career?This is your chance to join a high-performing teamthat values expertise, growth, and meaningful impact. We're expanding fast — and we're opening our doors to top healthcare talents ready to make a real difference.We havemultiple on-site opportunitiesacrossClinical, Operations, Training, and Quality— all...