USRN Clinical Analyst
Addforce HR Solutions Inc
- Quezon, PhilippinesGateway, 59 Aurora Blvd Araneta Center, Cubao, Quezon City, 1109 Metro Manila, PhilippinesQuezonMetro ManilaPhilippinesPhilippines
- Full timeFULL_TIME
Expired 7 years ago
2017-01-19T16:00:00+00:00Job closed.
Job Description
- Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
- Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources.
- Works with medical directors in interpreting appropriateness of care.
Minimum Qualifications
- Graduate of BS Nursing or any equivalent course
- With at least 3 months clinical or hospital experience
- Holds an active/inactive and unrestricted US Registered Nurse license
- Must be Philippines Registered Nurse
- Excellent written and verbal communication skills
- BPO experience is a plus!
Jobs Summary
- Job Level
- Entry Level / Junior, Apprentice
- Job Category
- Customer Service
- Educational Requirement
- Bachelor's degree graduate
- Recruiter response to application
- Sometimes
- Office Address
- Gateway, 59 Aurora Blvd Araneta Center, Cubao, Quezon City, 1109 Metro Manila, Philippines
Feel secure when applying: look for the verified icon and always do your research on a company. Avoid and report situations when employers require payment or work without compensation as part of their application process.
About Addforce HR Solutions Inc
ADDFORCE Human Resources Solutions Inc. is a Total Human Resource Provider, offering full wide-ranging and affordable services.
We specialize in Placement Services for rank-and-file positions, as well as Executive Search Services for Managerial and Top-level posts.