PHRN Operations Manager for Appeals Denials

The PH Registered Nurse (PHRN) collaborates with healthcare providers and members to promote quality outcomes, optimize member benefits, and ensure the effective use of healthcare resources. This role ensures that care provided is medically appropriate, high-quality, and cost-effective by reviewing medical necessity for inpatient admissions, outpatient...

Gratitude Inc. is a professional HR Tech Recruitment firm specializing in recruiting permanent, contract, and temporary positions for the world's top companies. Our base is in India, Philippines, Malaysia, and Africa. We are a direct sourcing partner Company of the different top BPOs offshore and onshore.We have an ongoing hiring for a Training Quality...

We are hiring a Service Operations Engineer II to provide L2 support to Enterprise clients via incident tickets and email. Responsibilities include logging all transactions in the ticketing system and resolving issues within SLA.Qualifications:Experience with Managed WiFi, SD-WAN, and Layer 2/3 technologies (MPLS, L3VPN, IPSEC, Routing & Switching)Familiar...

Job Summary:The Clinical Operations Manager is Responsible for Managing and Overseeing 'UM' (Utilization Management) Operations, Ensuring Compliance with Industry Standard(s) and Regulatory Requirement(s).As a Clinical Operations Manager – Your Role Involves Close Coordination with Various Stakeholder(s) to Drive Performance and Maintain High-Quality...

DIY Hardware, the fastest-growing home improvement center in the Philippines with over 75+ branches nationwide, is looking for a Store Maintenance & Layout Coordinator to oversee store maintenance, repairs, and layout execution.Responsibilities:* Oversee all store maintenance requests, including lighting, electrical, plumbing, flooring, and general repairs.*...

Principal Duties & Responsibilities:As an eCommerce Channel Operator at Etaily, you will play a pivotal role in enhancing your clients' digital presence across various online platforms and marketplaces. Your responsibilities will encompass creating compelling consumer-facing content, managing product selections, analyzing performance, and driving strategies...

Clinica Manila Pasig is looking for a competent and patient-focused Radiologic Technologist to perform diagnostic imaging procedures and support the daily operations of the Radiology Department.About the Role:The Radiologic Technologist will be responsible for operating imaging equipment to produce high-quality diagnostic images, ensuring patient safety and...

Job Description:The Executive Assistant to the VP for Sales & Marketing plays a vital role in supporting the VP's day-to-day activities and ensuring operational efficiency across the Sales and Marketing teams. This position handles high-level administrative tasks, confidential communications, financial documentation, site coordination, and interdepartmental...

Provides admin and Salesforce support to multiple Sales teams.Key Responsibilities:Manage sales records from lead to JO closure; ensure document accuracy and compliance.Upload/update Salesforce records and attachments.Monitor PD/TD/Reactivation.Run serviceability checks via Robot and update Salesforce.Perform general sales admin tasks.Qualifications:3–5...

Collaborate with the Marketing Team to design and implement visually appealing mock-ups for stores, ensuring they align with brand guidelines.Oversee the maintenance and operational upkeep of stores to maintain high standards.Coordinate with contractors to address and fulfill store requests promptly and effectively.Serve as the primary point of contact with...