Utilization Review Nurse Manager
NTT Business Process Outsourcing Quezon City Full-time
Roles and Responsibilities
- Provides front-line supervision to an operational team of 35 or more employees
- Supervised team typically responsible for managing US healthcare Payer claims adjudication process
- Assigns work to direct reports.
- Recommends and takes actions hiring, firing, promotion, and disciplinary recommendations.
- Supervises team ensuring the highest quality of service is provided to clients.
- Monitors performance of the team and reports results and issues to higher-level leadership.
- Assists team with escalated client or account issues.
- Manages hiring, staffing and maintaining a diverse and effective workforce.
- Interacts with clients and internal departments to resolve issues.
- Works with the team to complete assignments using established guidelines, policies and procedures.
- Demonstrates professional courtesy and represents the company in a positive manner in all areas of internal and external communications.
- Ensures appropriate record keeping, reports, and related administrative functions are accurate and up-to-date.
- Responsible for career development / planning, performance and pay discussions of team members.
- Upon request, compiles and analyses data to identify trends for root cause analysis.
- valid USRN License
- Typically requires 5- 9 years relevant experience
- Should be open to work in night shifts
- Undergraduate degree or equivalent combination of education and work experience.
- Solid communication skills.
- Demonstrated client service skills and leadership capabilities.
- Good knowledge, understanding and application of project management principles and methodologies.
- Models excellent analytical / problem solving skills.
- Good client service skills and leadership capabilities
- Solid analytical / problem solving skills.
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