Nurse Case Manager Jobs in Quezon City
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Search Results - Nurse Case Manager Jobs in Quezon City
Horizonccm-Manila, 10 km from Quezon City
Horizonccm is seeking a US-licensed Registered Nurse (USRN) to support case management, report preparation, and client-facing activities. This remote opportunity allows nurses to utilize their clinical writing and patient care skills effectively...
GH Premier Review Center Inc.-Quezon City
Excellent organizational and time-management skills.
• Strong communication, negotiation, and stakeholder-management skills.
• Strong problem-solving and decision-making abilities.
• Highly detail-oriented and capable of handling multiple cases...
Concentrix Philippines-Quezon City
Minimum 1 year of clinical nursing experience in hospital, clinic, or managed care setting Minimum 6 months of clinical process outsourcing experience with background handling clinical roles focusing on clinical appeals and utilization management Strong...
D.M. CONSUNJI, INC. (DMCI)-Quezon City
Provides first aid to patients and if necessary refers medical cases to nearby medical facilities / hospital accredited / contracted by the Company
• Implements health education program for the project workers and staff through lectures, information kit...
TECEZE-Quezon City
systems.
The role involves conducting initial patient assessments, determining the appropriate level of care, escalating urgent or critical cases, and ensuring accurate documentation in accordance with established clinical protocols.
Key Responsibilities...
Optum, a UnitedHealth Group Company-Quezon City
or a similar Utilization Review organization.
• Strong knowledge of case management, commercial insurance, Managed Medicare, Traditional Medicare processes, and patient status requirements .
• Experience with Clinical Documentation Improvement (CDI)...
View Moreicons-Quezon City
of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost...
Nurse Case Manager jobs – More cities:
Sagility Philippines B.V Branch-Quezon City
offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title: USRN Quality Analyst
Job Description Summary...
American Express-Quezon City
and resolution of assigned complaints received through the Global Complaints on CLIC (GCC) system. This includes maintaining case quality, supporting case integrity and managing inventory within business-identified SLAs.
Complaint research requires familiarity...
jobstreet.com -
Nezda Global-Quezon City
cases.
• Synthesize clinical information to provide expert medical determinations on requested services.
• Perform utilization management activities.
• Support opportunities across care management, disease management, quality management, pharmacy...
Quezon City
procedure manual.
• Assigns cases/activities and work within the client’s system to facilitate workflow and productivity goals.
• Refers cases requiring clinical review to a nurse reviewer. Performs case checks and reviews to ensure case creation...
accenture.com -
Our Clients-Quezon City
reimbursement outcomes through clinical documentation review, utilization management, and collaborative case assessment.
Key Responsibilities
• Conduct utilization review and evaluate medical necessity using established clinical criteria and guidelines...
careers-page.com -
Quezon City
Accurately routes cases to client medical staff for further review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
• Responsible for conducting medical management review activities which require...
accenture.com -
Concentrix-Quezon City
About the role
The Utilization Management (UM) PHRN is responsible for the review, processing, and resolution of UM cases. The role ensures timely and clinically sound UM review, upholding member rights and health plan obligations under commercial...
jobstreet.com -
Our Clients-Quezon City
reimbursement outcomes through clinical documentation review, utilization management, and collaborative case assessment.
Key Responsibilities
• Conduct utilization review and evaluate medical necessity using established clinical criteria and guidelines...
careers-page.com -
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