Job Description :
FOR THIS POSITION, PLEASE ATTACH YOUR UPDATED RESUME. JOBSTREET RESUME WILL NOT BE ACCEPTED. YOUR RESUME WILL BE PRE-SCREENED AND WE WILL CALL YOU IF YOU ARE DEEMED QUALIFIED FOR AN INTERVIEW.
YOUR MAY ALSO EMAIL YOUR RESUME TO ats siegensolutions.com AND PUT THE POSITION ABOVE AS THE SUBJECT. NO DOUBLE SUBMISSIONS PLEASE.
Responsible in collaborating with healthcare providers and members to promote quality member outcomes, to optimize membersâ
153; benefits, and to promote effective use of resources
Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources
Work with medical directors in interpreting appropriateness of care
BS Nursing (BSN) Degree
Active US State License holder
A minimum of three (3) monthsâ of prior working experience as a Registered Nurse in a clinical setting required
Three months is equivalent to 480 hours of working experience as an RN
Working experience as a Registered Nurse means holding an active RN license and providing direct patient care
Clinical setting includes inpatient hospital, outpatient hospital or clinic
Preferably (not a requirement, just an advantage) with 1 year of customer service or call-center experience and minimum of work experience
What we offer :
PHP150,000 SIGNING BONUS
Work in the Philippines, be with your family white earning good income!
Healthcare Insurance (HMO) & Life Insurance coverage from day 1 of employment
Expanded maternity leave up to 120 days*
Flexible Working Arrangements
Employee Stock Purchase Plan
Healthy and Encouraging Work Environment
Loyalty, Christmas Gift, Inclusion and Diversity Benefits