Senior USRN Clinical Specialist
Aces Call Center Jobs Inc.
Taguig, Metro Manila, Philippines
1d ago
source : Kalibrr, Inc.

Job Description

  • Perform Utilization Management reviews in accordance with federal state mandated regulations.
  • Utilizes the member’s contract to determine coverage eligibility.
  • Works with providers and take action while exhibiting judgment and a realistic understanding of the issues.
  • Liaise with research team in order to accurately collect and record data.
  • Independently facilitates design of clinical workflow in collaboration with clinicians.
  • Minimum Qualifications

  • FILIPINO with active PHRN and USRN licenses (unrestricted U.S. Registered Nurse license from any Mainland US State)
  • Bachelor of Science Nursing (BSN)
  • Willing to work on rotating shifts and to be assigned in Taguig (Fort Bonifacio McKinley)
  • With at least 2 years of clinical experience
  • With at least 2 years experience handling utilization review for healthcare account in a BPO setting
  • Knowledgeable about nursing principles, techniques, and procedures for the care of patients
  • Knowledgeable about medical terminology, anatomy, physiology, and concepts of disease
  • Excellent written and verbal communication skills in English
  • Apply
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