MetHealth USRN - InterQual Account

MetHealth

Urgente

€602-1.2K[Mensual]

Hibrida - Cebú1-3 años de experienciaBaceleroTiempo completo

Reconocimiento y Recompensas de Empleados
Bono de rendimiento, Regalos de Aniversario, Empleado del Premio Mes, Programa de Reconocimiento de Empleados, Regalos de Navidad
Beneficios Mandados del Gobierno
Pago del mes 13, Préstamo de Empleados, Fondo Pag-Ibig, Vacaciones pagadas, Salud, SSS/GSIS
Seguro de salud y bienestar
Seguro de salud, Seguro de vida, HMO
Desarrollo profesional
Programa de Asistencia a Empleados, Desarrollo profesional, Programa de Becas

Health Insurance Education & Support: Assist patients with understanding insurance coverage, claims results, and care navigation across complex medical conditions and multi-provider coordination.
Leadership & Mentorship: Act as a clinical resource for less experienced team members, provide coaching and feedback, and support professional development within the team.
Complex Problem Solving & Analysis: Solve moderately to highly complex problems by interpreting clinical data, identifying trends, and offering actionable solutions with minimal supervision.
Research & Evidence-Based Review: Conduct non-clinical research to support benefit determinations and ensure that final decisions are grounded in the latest clinical evidence and standards.
Documentation & Reporting Excellence: Maintain high standards of accuracy and timeliness in clinical review documentation, ensuring all decisions are well-supported and communicated to stakeholders.
Temporary Work-From-Home Setup

Must have At least 2 Years Hospital Experience
2 years Healthcare BPO Experience (As Utilization Management or Clinical Denial and Appeals)
Active USRN License
Must have knowledgeable with Interqual Or MCG Guidelines System
Must Be Amenable To Work On-Site For The First 2 Weeks To Get The Assets or Equipment