URGENT HIRING FOR USRN'S WITH MILESTONE BONUS OF 340K *

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Responsibilities

WHAT WE OFFER:

 

  • RN Allowance

  • Free Continuing Professional Development Courses (CPD Units)

  • USRN Sponsorship

  • Market Competitive Pay Levels

  • Retirement Plan

  • Medical Plan (HMO)

  • 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

  • Recognition

  • Training and Staff Development

  • Employee Referral Program

  • Employee Volunteerism Opportunity

  • All Mandatory Statutory Benefits

     

Primary Responsibilities:

  • Act as a Subject Matter Expert for other team members
  • Manage the intake of members or the admission/discharge information post notification
  • Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and/or providers
  • Manage the referrals process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles
  • Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
  • Process notification requirements
  • Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
  • Handle resolution/inquiries from members and/or providers that may include:
    • Benefit and Eligibility information
    • Billing and Payment issues
    • Customer material requests
    • Physician assignments
    • Authorization for treatment
    • Explanation of Benefits (EOB) 

Requirements

  • At least 2 year(s) of working experience in the related field is required for this position.
  • Candidate must possess at least a Professional License (Passed Board/Bar/Professional License Exam) on Nursing.
  • Preferably Junior Associate (1-4 yrs experience) specializing in Healthcare - Nurse/Medical Support and Assistant or equivalent.

Additional Requirements

Qualifications:

  • BS Nursing graduate with license in both PH and US

  • Experience working in a Hospital, Physician's Office or Medical Clinical setting (2 years)

  • Experience working within the Healthcare Industry

  • Working knowledge of Medical Terminology to communicate with members and providers

  • Ability to create, edit, save and send documents utilizing Microsoft Word and Excel

  • Ability to navigate a PC to open applications, send emails and conduct data entry

  • Professional experience in a clerical or administrative support related role

  • Experience working with Healthcare Insurance

Additional Information

  • Location: Taguig City, NCR.
  • Full Time position(s) are available.
  • Number of vacancies: 50.

Careers at Optum

If you’re going to change careers, why not look for an employer that’s out to change everything? If you have that kind of appetite for change, Optum is the right place for you. As part of the growing UnitedHealth Group family of businesses, we’re driving innovation and change all over the world. That’s creating opportunity right here in the Philippines for people with energy, passion and a focus on quality. We’re driven to help people live healthier lives and to helpmake the health care system work better for everyone. We want to make a difference and that makes this the one job opportunity that can change everything for you.