Registered Physical Therapists / Registered Occupational Therapists / Registered Nurse
Revupoint Inc
Metro Manila,Southern Tagalog, PH
3d ago
source : Monster

•Evaluate the appropriateness, medical need and efficiency of health care services, procedures and facilities according to established criteria or guidelines and under provisions of an applicable health benefits plan.

It includes new activities or decisions based on the analysis of a case.

  • •Drafts utilization review reports assessing medical necessity of procedures recommended for injured workers. Includes analysis and summarization of submitted medical records;
  • identification of applicable evidence based medicine citations; draft of determination versus specification of question for physician advisor.

    •Process cases according to applicable client and state-specific guidelines and routing them accordingly to proper groups or persons to ensure timely and efficient delivery of medical determinations.

    In order to be considered for the position, an applicant must possess :

    •Bachelors or greater degree either in Physical Therapy, Occupational Therapy or Nursing. Fresh graduates are very much welcome to apply.

    •Proficient in computer use of internet and Microsoft Office.

    •Excellent command of both written and spoken English.

    •Interested in expanding knowledge base and willing to benefit from significant education with frequent feedback.

  • •Ability to assess records to determine the critical information that is necessary to determine if a request is medically necessary;
  • compare that information to evidence based medicine guidelines; and draft a determination recommendation with rationale for determination OR identify specific question for the physician advisor to quickly assess and recommend a determination with rationale for that determination.

    Interested individuals may send their comprehensive resume to qrediestomata to expedite the application process.

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