Job Description

Sutherland Taguig, National Capital Region, Philippines

The role involves clinical operations across Utilization Management and Care Management, including:

• Reviewing medical documentation and pre-authorization requests
• Conducting concurrent and retrospective reviews
• Managing member care coordination, follow-ups, and clinical documentation
• Voice & Non-Voice communication with members

Qualifications

• Active USRN or PHRN license
• Good to excellent English communication skills
• No clinical and BPO experience required but preferred

Job Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Customer Service
• Industries: IT Services and IT Consulting
• Location: Taguig, National Capital Region, Philippines