URGENT HIRING | PHRN Ops Manager | 150K

2 days ago


Manila, National Capital Region, Philippines Global Group Innovative Services, Inc. Full time
Key Responsibilities
  • Oversee end-to-end UM operations and ensure SLA and quality compliance
  • Manage profitability, seat utilization, and retention performance
  • Lead and coach a clinical team of up to 100 employees
  • Ensure adherence to MCG, InterQual, NCQA, and ODG guidelines
  • Build strong client relationships and conduct regular business reviews
  • Collaborate with internal support teams (Training, QA, WFM, HR, etc.)
  • Drive engagement, recognition, and performance improvement initiatives

Qualifications

Active Philippine RN License (PHRN)

Minimum 1 year experience as a Manager in a Healthcare BPO or UM environment

Strong background in Utilization Management and Clinical Appeals

Proficient in MCG, InterQual, NCQA, and ODG guidelines

Excellent communication, leadership, and analytical skills

Amenable to onsite work in Bridgetowne, Quezon City

Flexible with schedule and shift assignments



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