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- ...Kickstart the new year with a leadership role in healthcare! Join a proudly Filipino-owned global company and be part of a pioneer Utilization Review team. Qualifications BS Nursing graduate with active USRN license 1-2 years Team Lead / QA experience 3-5 years...
Visaya KPO
Pasig16 days ago - ...Discover your 100% YOU with MicroSourcing! Position: Utilization & Denials Management Manager Location: Taguig Work setup & shift: Onsite | Night shift Why join MicroSourcing Youu0027ll have: Competitive Rewards...
- Some careers shine brighter than others. If you’re looking for a career that will help you stand out, join HSBC and fulfil your potential. Whether you want a career that could take you to the top, or simply take you in an exciting new direction, HSBC offers opportunities...
- Just imagine your future with us At Aurecon we see the future through a very different lens. Do you Innovation eminence and digital are at the heart of everything we do. Are you excited about the future Are you driven by the opportunity to work on some of ...
- ...and capability development. Support pricing strategy and profitability analysis in coordination with Sales Ops and Finance. Utilize customer segmentation and product-positioning models to formulate and execute effective messaging, concept marketing techniques, and...
- Job Title: Operations Manager - Utilisation Management (USRN Required) Shift: Night shift (aligned with US hours) Work Set-up: On-site in Bridgetowne, Quezon City Salary Range: PHP 150,000 - 180,000 Start Date: December 31, 2025 or ASAP Line of Business ...
- ...Regularly check and confirm that the content on the LMS matches the published documentation versions. Microsoft Office Proficiency: Utilize Excel for data management and PowerPoint for creating compelling presentations. Content Review and Updates: Continuously...
720000 Php per year
...production quality across the design team. Help optimize creative workflows and adopt best practices for hybrid work environments. Utilize AI tools and emerging technologies to enhance creative efficiency and ideation. Participate in client calls or internal...- Job Description: The Reviewer is responsible for assessing the delivery of medical services to determine if the care provided is appropriate, medically necessary, and of high quality. This includes examination of documents to see if patients are given care consistent ...
- ...levels of customer service by providing tailored solutions based on each customers unique situation including programs related to utilities such as electricity billing water gas and energy. Key Responsibilities Engage with customers through email chat or phone depending...
- ...coordinate with organization's support staff, third parties, and carriers on Level-1 and above portions of the network, from end-users utilizing VPN connections, our Regional Sales Offices, Distribution Centers, and Headquarters Staff to cloud service providers. This is a...
- ...documentation of all interactions, resolutions, and follow-up actions taken. . User Training and Education: Assist end-users in utilizing IT systems, software applications, and hardware devices effectively by providing training, guidance, and self-help resources to...
- ...employee experience. Every day we do this with excellence, respect, integrity, and utmost professionalism. Candidate Profile: As Utility Staff, you must share our core values, has initiative, hardworking, physically fit, and detail-oriented. Job Objectives: To...
- ...Develop training materials, including job aids, user guides, and facilitator materials, tailored to client-specific workflows. Utilize various learning methodologies and tools to deliver engaging and effective training sessions. Standardize training...
- ...Assist employees with HMO availment, LOA processing, and clinic/hospital referrals. Liaise with HMO partners and providers; track utilization and common case trends for reporting. Occupational Safety & Compliance Support OSH programs (with the Safety Officer),...
- ...inquiries and collecting necessary documentation. Participate in employee engagement activities that promote benefits awareness and utilization. Respond to employee inquiries regarding benefits programs and assist with resolving issues. Requirements Must be...
- ...JOB SUMMARY The Utility Staff is responsible for ensuring that the clinic premises are consistently clean organized and well-maintained. This role plays a critical part in creating a safe hygienic and welcoming environment for patients visitors and staff. The position...
- Grievance & Appeals ~ Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation. ~ Creates a detailed case summary in narrative format for each appeal. ~ Submits...
- ...issue. Ensures to provide first call resolution with confidentiality to customers concerns and properly set expectations while utilizing available resources. Be able to identify customer’s concerns through phone; which includes but not limited to basic troubleshooting...
- ...Benefits Flexible working environment Volunteer time off LinkedIn Learning Employee-Assistance-Program (EAP) NIQ may utilize artificial intelligence (AI) tools at various stages of the recruitment process, including résumé screening, candidate assessments,...
- ...by developing documentation and flowcharts. Prepare and maintain code for applications and resolve any defects in the system. Utilize established development tools guidelines and conventions including but not limited (.NET Core 6 .NET Framework) SQL Server MVC HTML...
- ...ensure that the offerings are in line with the requirements for the region/BU Qualifications Experience: Proficiency in utilizing virtual training software, such as Teams or Zoom Technical competency and proficiency in Microsoft Office Suite Displays a...
- ...by developing documentation and flowcharts. Prepare and maintain code for applications and resolve any defects in the system. Utilize established development tools guidelines and conventions including but not limited (.NET Core 6 .NET Framework) SQL Server MVC HTML...
- ...Career Opportunity: Utilization Management US Registered Nurse Senior Analyst Grievance & Appeals • Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation. • Creates...
- ...in clinical practice and health information management. Key Responsibilities: • Review and analyze clinical documentation, utilization records, and insurance denial rationales to formulate well-constructed appeal cases. • Engage in the appeals process for denied...
- ...is a bit more complex than consumer selling and requires a little more depth and sophistication from the sales business manager. Utilize a consistent contact attempt process via phone and e-mail to nurture, qualify and sell prospects generated by marketing campaigns...
- ...call and/or ticket case handling for accuracy of information in accordance with client-specific guidelines. . Record evaluations utilizing departmental quality monitoring forms. . Deliver coaching feedback to agents on call performance. . Provide Supervisors and...
- ...sessions. Lead knowledge transference and best practices in facilitation by conducting sessions with trainers/ facilitators utilizing the materials and assets designed and developed for a particular course Provide feedback to identified participants after the...
- ...ensuring that these are carried out efficiently Help product team prioritize features by bringing in market and customer context Utilize various marketing channels (e.g. LinkedIn, social media, brochures, etc.) and formulate compelling messages to drive inbound and...
- ...manager Reporting analytics & System management ~ Implementing and management of DMS (Distributor Management system) to capture and utilize advanced analytics to optimize and pursue business opportunities with local teams and CPs. Facilitate audit & monitoring...
