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Apply for Instant screeningPioneeer PHRN Account - Libis
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1880 Eastwood Avenue, Bagumbayan, Quezon City, Metro Manila, Philippines
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25 Openings
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> 6 months
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30k/Month
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30000/Month
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2000/Month
Job Pitch
Creating opportunities for all! Join our newest PHRN Team. Hiring for our Libis 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
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Day 1 HMO for Dependent
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Day 1 HMO
Allowances And Incentives
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Monthly Performance Incentive
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Retirement Benefits
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Annual Performance Bonus
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Free Parking
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Cell Phone Allowance
Medical Benefits
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Medicine Reimbursement
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Free HMO for Dependents
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Critical illness Benefits
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Life Insurance
Day 1 HMO
Work From Home 
14th Month Pay 
Day 1 HMO for Dependent
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