Alabang Site

Pioneeer PHRN Account - Alabang

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Pioneeer PHRN Account - Alabang

  • Northgate Cyberzone Northgate Avenue, Alabang, Muntinlupa, Metro Manila, Philippines

  • 25 Openings

  • > 6 months

  • 30k/Month

  • 30000/Month

  • 2000/Month

Job Pitch

Creating opportunities for all! Join our newest PHRN Team. Hiring for our Alabang site.

Job Description

Job Description: • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function • Gathers clinical information and applies the appropriate medical necessity criteria / guideline, policy, procedure and clinical judgment to render coverage determination/recommendation/discharge planning along the continuum of care • Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support) • Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment • Identifies members who may benefit from care management programs and facilitates referral • Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization Qualifications: • Must have an active PRC License • At least 6 months Healthcare BPO Experience, preferably with UR (Utilization Review) or Clinical Experience • Must be willing to work onsite if the business/client requires

Skill Required

  • Calm Under Pressure
  • Attention to Detail
  • Positive Attitude

Qualification Required

  • College Graduate
Top Picks
  • Day 1 HMO for Dependent
  • Day 1 HMO
Allowances And Incentives
  • Monthly Performance Incentive
  • Retirement Benefits
  • Annual Performance Bonus
  • Free Parking
  • Cell Phone Allowance
Medical Benefits
  • Medicine Reimbursement
  • Free HMO for Dependents
  • Critical illness Benefits
  • Life Insurance

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