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Posted:3 Hari
Durasi kerja:
Permanent
Bidang Karir:
Health and Safety
Gaji (Bulanan):
20,500,000-31,000,000 PHP
Kualifikasi yang diperlukan:
Bachelor degree
Pengalaman minimal yang diperlukan:
5 years
Lokasi Pekerjaan:
Ortigas Center, Pasig City, Metro Manila, Philippines
Keterangan:
Key Responsibilities:
1. Clinical Care Coordination: Evaluate patient care needs and coordinate with healthcare providers to ensure quality treatment plans while optimizing member benefits.
2. Utilization Management: Conduct utilization reviews using evidence-based guidelines to determine medical necessity and appropriate care settings.
3. Provider Collaboration: Communicate directly with physicians and specialists regarding patient diagnoses, treatment plans, and timely discharge coordination.
4. Patient Advocacy: Assist patients with healthcare coverage questions and support them in managing complex medical conditions through high-quality care service coordination.
5. Clinical Documentation: Review and analyze medical records, laboratory results, and diagnostic tests to validate claims and ensure appropriate treatment recommendations.
Job Qualifications:
1. At least 3 to 5 years of experience in Utilization and Authorization Management.
2. Alternatively, at least 3 years of experience in a hospital setting.