Operations Manager – Utilization Management

2 weeks ago

Quezon City, National Capital Region, Philippines Nityo Infotech Full time ₱80,000 - ₱120,000 per year

Responsibilities:

  • Oversee daily operations and ensure compliance with SLAs and regulatory standards.
  • Develop and implement process improvement initiatives.
  • Manage team performance and resource allocation.
  • Collaborate with internal and client stakeholders to enhance service delivery and maintain accurate staffing.
  • Ensure adherence to HIPAA and other regulatory requirements.
  • Well versed in Medical Guidelines (e.g. MCG, Interqual, NCQA, ODG)
  • Experience in managing teams handling Clinical Appeals

Bachelor's Degree in Nursing Graduate

US Registered Nurse (Active License; Compact License)

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