USRN Case Manager Nurse

1 week ago

Ortigas Metro Manila, Philippines VEE HEALTHTEK PH INC. Full time ₱1,200,000 - ₱2,400,000 per year

The Case Manager Nurse will regularly liaise with multiple clinical specialties and doctors. This role also involves consistent interactions with insurance providers, patients and their families, legal delegates, and representatives from other medical care institutions. Additionally, they will often communicate with nursing staff, billing teams, medical social workers, and personnel from various departments.

Primary Roles Responsibilities

· Performs case management including obtaining prior authorization for drugs and procedures according to hospital policy and procedures.

· Promotes, coordinates, and takes responsibility for completion of all activities associated with case management.

· Ensure that all patient information is handled in accordance with HIPAA regulations.

· Ability to perform tasks in line with authorizations for outpatient services, denial letters, and similar activities.

Qualifications:

· Graduate of BS Nursing, USRN required.

· At least 2 years previous hospital nursing experience or Case Management experience in a clinical setting for a US-based healthcare company, required.

· Excellent verbal and written communication skills

· Experience with Prior Authorization / Case Management / Utilization Review

· Proficient computer and software skills

ADDITIONAL REQUIREMENT:

  • Strong nurse with experience in acute oncology care , case management , utilization review
  • Prior authorization experience
  • Willing to work in Ortigas in an onsite work arrangement.
  • Amenable to work in a graveyard shift schedule.
  • Must be a USRN/NY Licenses

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