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USRN and NCLEX Passers | Day 1 HMO plus Retirement Benefits!

USRN and NCLEX Passers | Day 1 HMO plus Retirement Benefits!

Optum

Optum 34.13 km

Earn Up to 80,000 Monthly

  • Day 1 HMO Day 1 HMO

No BPO experience? Apply Now as Customer Service Support | Day 1 HMO @ Alabang

No BPO experience? Apply Now as Customer Service Support | Day 1 HMO @ Alabang

Optum

Optum 34.13 km

Earn Up to 17,000 Monthly

  • Day 1 HMO Day 1 HMO

URGENT HIRING! Customer Service Representatives for Alabang Site! Day 1 HMO

URGENT HIRING! Customer Service Representatives for Alabang Site! Day 1 HMO

Optum

Optum 34.13 km

Earn Up to 17,000 Monthly

  • Day 1 HMO Day 1 HMO

Newbie? Apply now as Customer Support Representative | Earn up to 23K - Alabang

Newbie? Apply now as Customer Support Representative | Earn up to 23K - Alabang

Optum

Optum 34.13 km

Earn Up to 17,000 Monthly

  • Day 1 HMO Day 1 HMO

Customer Service Representatives in Quezon City | No BPO exp required

Customer Service Representatives in Quezon City | No BPO exp required

Optum

Optum 34.13 km

  • Day 1 HMO Day 1 HMO

Hiring for Customer Support - Quezon City | Day 1 HMO

Hiring for Customer Support - Quezon City | Day 1 HMO

Optum

Optum 34.13 km

  • Day 1 HMO Day 1 HMO

Customer Service Reps in Cebu | Fresh grads are welcome to apply

Customer Service Reps in Cebu | Fresh grads are welcome to apply

Optum

Optum 34.13 km

  • Day 1 HMO Day 1 HMO

Customer Care Specialist in Quezon City site | Earn up to 23k!

Customer Care Specialist in Quezon City site | Earn up to 23k!

Optum

Optum 34.13 km

  • Day 1 HMO Day 1 HMO

Join our speed hiring in Makati & be a Customer Service Specialist!

Join our speed hiring in Makati & be a Customer Service Specialist!

Optum

Optum 34.13 km

Earn Up to 18,000 Monthly

  • Day 1 HMO Day 1 HMO

We are looking for you! Apply now as Customer Service Specialist in Taguig site.

We are looking for you! Apply now as Customer Service Specialist in Taguig site.

Optum

Optum 34.13 km

Earn Up to 18,000 Monthly

  • Day 1 HMO Day 1 HMO

No BPO experience? Apply today as Customer Service Rep at Cebu site

No BPO experience? Apply today as Customer Service Rep at Cebu site

Optum

Optum 34.13 km

  • Day 1 HMO Day 1 HMO

Instructional Designer | Hybrid with up to 90K Sign-on Bonus

Instructional Designer | Hybrid with up to 90K Sign-on Bonus

Optum

Optum 34.13 km

Earn Up to 37,000 Monthly

  • Day 1 HMO Day 1 HMO

Workforce Capacity Planner | Up to P140K sign-on bonus!

Workforce Capacity Planner | Up to P140K sign-on bonus!

Optum

Optum 34.13 km

Earn Up to 37,000 Monthly

  • Day 1 HMO Day 1 HMO

USRN and NCLEX Passers | Day 1 HMO plus Retirement Benefits! Optum - USRN and NCLEX Passers | Day 1 HMO plus Retirement Benefits!

Location McKinley Hill Drive, Taguig, Metro Manila, Philippines

Job Pitch

WHAT WE OFFER

  • Market Total Rewards Package
  • Temporary work from Home / Laptop Provided
  • Retirement Plan
  • Medical Plan (HMO) from Day 1 of employment
  • Dental, Medical, and Optical Reimbursements
  • Life and Disability Insurance
  • Paid Time-Off Benefits
  • Sick Leave Conversion
  • Tuition Fee Reimbursement
  • Employee Assistance Program (EAP)
  • Annual Performance Based Merit Increases
  • Employee Recognition
  • Training and Staff Development
  • Employee Referral Program
  • Employee Volunteerism Opportunity
  • All Mandatory Statutory Benefits

 

WHO WE ARE

  • Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
  • UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
  • We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.
  • As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.
  • We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.
  • Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together

Job Description

*Pooling candidates in preparation for 2025 classes

ROLE AND RESPONSIBILITIES

  • Function is responsible for performing pre-service clinical coverage review of services that require notification, using applicable benefit plan documents, evidence-based medical policy and nationally recognized clinical guidelines and criteria. Determines medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination.
  • Conduct Non-Clinical Research to Support Determinations. Determine that the case is assigned to the appropriate team and health plan for review (e.g., Medicare, Medicaid, Commercial, Dual Special Needs Plan)
  • Review Existing Clinical Documentation. Review/interpret clinical/medical records submitted from provider (e.g., office records, test results, prior operative reports)
  • Make Final Determinations Based on Clinical and Departmental Guidelines. Understand and adhere to applicable legal/regulatory requirements (e.g., federal/state requirements, HIPAA, CMS, NCQA/URAC accreditation)
  • Achieve and Maintain Established Productivity and Quality Goals. Adhere to relevant quality audit standards in performing reviews, making determinations and documenting recommendations.

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life’s best work.SM.

 

JOB QUALIFICATIONS

  • Valid and unrestricted USRN license and PHRN License required
  • Must have a minimum of 2 years hospital (bedside)  experience
  • Preferably with a minimum of 2 years BPO experience related to Utilization Management or Case Management
  • Clinical competence in understanding 

Skills Required

  • Creative Thinker
  • Problem Solving Skills
  • Analytical Skills
  • Calm Under Pressure
  • Open to Flexible Schedules
  • Attention to Detail
  • Empathetic to Customers
  • Positive Attitude
  • Strong Communication Skills

Qualification Required

  • College Graduate

What this jobs offers

Optum About Optum Read more about Us

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Being a part of Optum means working to improve health outcomes for everyone, including yourself. Here is how:

·        Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. Learn more about what we offer. 

·        Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. Learn more about our culture. 

·        Growing together. Optum is full of inspiring career stories, and we offer a lifetime of opportunities. Discover all the ways you can learn, grow and develop. 

 

 

UnitedHealthcare and Optum make up UnitedHealth Group as two distinct but complementary businesses, working to build a better health system for all.  

 

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