- Performs Utilization Management (UM) reviews in accordance with U.S. State/Federal and other mandated regulations.
- Maintains compliance with regulatory changes affecting UM.
- Reviews UM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer or prescribed escalation protocol.
- Releases UM determinations to claim stakeholders following client-established protocols.
- Maintains all required UM review documentation in the UM software in a timely manner.
- Serves as first level contact for customer concerns pertaining to UM reviews.
USRN - Utilization Management Nurses
Permanent Work from Home Set-up
Salary P75,000 to P85,000 plus Signing Bonus P150,000
- Holder of Active USRN License from any Mainland State
- With 2 years utilization management experience gained from working in the BPO industry or any US healthcare company
- Willing to work on night shift - rotational weekends off
- Must be residents of Greater Metro Manila area (provincial candidates outside of Metro Manila, Laguna, Cavite, Rizal and Bulacan will not be considered)
Fasilitas dan Tunjangan
- Medical / Health Insurance
- Paid Sick Leave
- Performance Bonus
- Recruitment / Signing Bonus
- Paid Holidays
- Paid Vacation Leave
- Maternity & Paternity Leave
Lisensi dan Sertifikat
- Tingkat Posisi
- Lulusan Baru / Junior
- Health and Medical
- Persyaratan tingkat pendidikan
- Lulus program Sarjana (S1)
- Respon rekruter ke lamaran
- Alamat Kantor
- Fort Bonifacio, Taguig City, National Capital Region, Philippines
- Call Center / BPO
- 15 lowongan dibuka
Tentang Aces Call Center Jobs Inc.
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