Clinical Appeals Medical Doctor

Job descriptionWhat You'll Do Lead and oversee multiple Medical & Clinical Operations functions Provide clinical guidance to staff (disease state, health conditions, care navigation) Review and oversee coordination of care (chronic condition management, utilization management, case management) Develop, review, and approve policies and procedures for medical...

Forever Flawless Face and Body Center, Inc. (Flawless) is a leading aesthetic beauty clinic in the Philippines, offering face, body, and medical services. Flawless is known for its innovative aesthetic services and exceptional customer service. The brand, led by CEO Rubby Sy, has received awards for its outstanding achievements in the beauty industry.Role...

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...

JOB DESCRIPTION:Assists the Medical Director and/or Medical Affairs Head in the daily operations of the Medical Affairs Department and in doctor engagement.Coordinates with the Medical Director and/or Medical Affairs Head in handling unusual and difficult cases and gives recommendations on a variety of medically related problems.Conduct research on medically...

Aesthetic PhysicianJob Overview:We are looking for a skilled and patient-centered Aesthetic Physician to join FULL TIME TO our team. The physician will primarily perform non-surgical aesthetic procedures, including lasers, dermal fillers, and other body treatments, while ensuring patient safety, comfort, and satisfaction.Key Responsibilities:Perform...

Urgent Hiring - Medical DoctorCompany: OptumHiring Process: VirtualRequirements:Must hold an active, unrestricted Doctor of Medicine licensure in the PhilippinesMust be an Internal Medicine DiplomateMust have recent hospital experienceWilling to work full-time, report in a hybrid setup in either Makati or Alabang and commit to a night shift scheduleDM me the...

About the RoleWe are seeking a dedicated, full-time Aesthetic Doctor to join our team at Aesthetic Science Clinic. This is a long-term, exclusive role for someone ready to grow within a doctor-led, premium aesthetic clinic with over 20 years of experience in delivering safe, science-backed, and patient-focused care.The ideal candidate is committed to safety,...

Scheduling of Consultations.Assists patient in scheduling consultation with the physician.Patient monitoring.ASSISTS physician in providing medical treatment plan to patients such as prescribed medicines, vaccines, cleaning and dressing wounds and changing bandages.ANALYZES the assessment and findings of the patient, and endorse to clinic's Occupational...

Operations Manager for Appeals - PHRNLOB DESCRIPTION: Medical necessity review for appeals (Claims denied due to medical necessity)JOB SUMMARY:The Operations Manager for Appeals is responsible for managing and overseeing operations related to clinical appeals, ensuring compliance with industry standards and regulatory requirements. The role involves close...