General Transaction Processing
Manila, Philippines
7d ago

Job description

Effectively leads a team to meet the set goals and ensure compliance to Accenture policies and Client care management BPO service processes.

Responsible to serve as team lead to include in all or part :

  • Utilization Management to provide support to the clinical team and client team to assist in the promotion of quality member outcomes, to optimize member benefits, and to promote effective use of resources.
  • Supports the procedures that ensure adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.

    Gathers information and conducts pre-review screening under the guidance and direction of US licensed health professionals.

  • Case Management / Disease Management - to provide support may be gathering of information and support functions for wellness programs, health management programs and preventative care opportunities that the member may have as part of their benefits.
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