UnitedHealth Group Nurse Case Coordinator - Taguig City, NCR in Taguig City, Philippines
Welcome to one of the toughest and most fulfilling ways to help people, including yourself.
We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement.
Join us and start doing your life's best work.(sm)Optum, part of the UnitedHealth Group family of businesses is working to create the health care system of tomorrow.
Already Fortune 6, we are totally focused on innovation and change.
We work a little harder.
We aim a little higher.
We expect more from ourselves and each other.
And at the end of the day, we're doing a lot of good.Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever.
Now we're looking to reinforce our team with people who are decisive, brilliant and built for speed.Positions in this function are responsible for reviewing, researching, investigating, and triaging all types of appeals and grievances.
This role will communicate with appropriate parties regarding appeals and grievance issues.Primary Responsibilities: Ensure complaint has been categorized correctly Determine and confirm member eligibility and benefits Obtain additional documentation required for case reviewPlace relevant documents into image repository Initiate outbound contact to members or providers Review case to determine if review by Clinician is required Research and resolve written complaints submitted by consumers and physicians/providersRender decision for non-clinical complaints using sound, fact-based decision making Draft verbiage for use in outbound correspondence Prioritize and organize tasks to meet compliance deadlines Ability to meet established productivity, schedule adherence, and quality standards Required Qualifications: Philippine Registered Nurse (RN) Licensed with a minimum of 2 years hospital experience in any of the following areas: - ICU - Emergency Room - Medical-Surgical - Operating Room / PACU - Cardiac / Telemetry - Academe (Clinical Instructors) - Psych (will have to closely assess clinical/critical thinking skills) Strong verbal communication skills with Versant of 60 and aboveTyping: Minimum typing speed of 40 WPM with 95% accuracyWilling to work odd hours (11pm-8am, 12mn-9am) and/or weekends & holidaysPreferred Qualifications: Experience with BPO Healthcare/Pharmacy industry combined with hospital experienceModerate proficiency with computer and Windows applications, which includes the ability to learn new and complex clinical system applicationsTake the next step, online at: www.yourlifesbestwork.com Careers with Optum.
Here's the idea.
We built an entire organization around one giant objective; make health care work better for everyone.
So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.
Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential.
For you, that means working on high performance teams against sophisticated challenges that matter.
Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm) Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Optum is a drug-free workplace.
© 2017 Optum Global Solutions (Philippines) Inc.
All rights reserved. Job Keywords: Nurse Case Coordinator, PHRN, Philippine Registered Nurse, RN, Registered Nurse, ICU, Intensive Care Unit, Emergency Room, Medical-Surgical, Operating Room, PACU, Cardiac, Telemetry, Academe, Psych, Hospital, Taguig City, NCR, National Capital Region 9b0b1a1f-28ac-45d8-bd02-ade96aa6a159
Nurse Case Coordinator - Taguig City, NCR Philippines-Taguig City 728271