Healthcare Manager

2 weeks ago

Mandaluyong City, National Capital Region, Philippines BIITECH, LLC Full time

Job Title: Manager | Healthcare

Work Location:
EDSA Greenfield (Mandaluyong)

Work Setup:
Onsite

Work Schedule:
Onsite / Shifting as required

Salary Range:
Open (based on experience)

Recruitment Process:


• 2-Level Interviews


• Leadership Assessments

Job Summary

The
Healthcare Manager
will lead clinical operations, ensuring compliance with healthcare standards while managing performance, quality, and service delivery. The role requires strong nursing expertise, operational leadership, and familiarity with US healthcare guidelines including Utilization Management (UM), Case Management (CM), and MCG/InterQual criteria.

You will oversee strategic planning, team supervision, client coordination, and clinical compliance across multiple workflows.

Key Responsibilities

  • Provide strategic direction and operational oversight for healthcare programs.
  • Lead, mentor, and manage clinical staff to meet performance, quality, and compliance standards.
  • Ensure adherence to Utilization Management, Case Management protocols, and payer-specific guidelines.
  • Review and interpret
    MCG/InterQual
    guidelines for clinical decision support.
  • Ensure compliance with
    Medicare/Medicaid
    policies and clinical documentation requirements.
  • Handle escalation management, capacity planning, and operational improvements.
  • Collaborate with clients, internal stakeholders, and cross-functional teams to achieve performance outcomes.
  • Implement continuous improvement initiatives and drive clinical workflow optimization.
  • Monitor KPIs, conduct audits, and report operational performance to senior leadership.

Basic Requirements

  • Bachelor's Degree in Nursing
    (BSN) –
    PH RN and US RN licenses required
    .
  • 5+ years of relevant experience
    in clinical management, healthcare operations, or UM/CM leadership.
  • Strong knowledge of:
  • • Utilization Management
  • • Case Management
  • • MCG/InterQual criteria
  • • Medicare/Medicaid guidelines
  • Excellent communication, leadership, stakeholder management, and analytical skills.
  • License validity must be at least 6 months
    .
  • If validity is less than 6 months or missing on the CV, the candidate is automatically disqualified.

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