USRN/ PHRN Team Leader

Gratitude Inc

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1 month ago

USRN/ PHRN Team Leader

1-3 Year(s)

70 - 120 Thousand p.m

Manila (Cubao Quezon City)

Job Description

Key Skills

Strong communication and interpersonal skills

1 candidate(s) have already applied for this Job. Apply now

QUALIFICATIONS:

• Bachelor's Degree in Nursing with an active and valid license in PHRN or USRN

• Minimum of 1 year InterQual criteria experience

• Minimum of 2 years bedside experience as an ER or ICU nurse (Acure Care bedside experience)

• Must have experience in utilization management with a US-based insurance company or hospital (or equivalent)

• Experience as a Team Lead or Supervisor for at least 1 year, in a similar support environment - other related roles exposed to related functions are also considered.

• Experience in a hospital setting or other clinical environment/ contact center setting

• Excellent verbal and written communication skills

• Strong attention to detail and case documentation practices

• Ability to manage multiple cases and meet regulatory turnaround time under pressure

• Proficient in basic Microsoft Office applications such as Word, Excel, and Outlook

• Strong clinical knowledge, particularly in medical necessity review and interpretation of clinical documentation

• Good knowledge and understanding of different healthcare insurance processes, appeals, grievances, and utilization management is preferred

• Willingness to work on-site with flexible schedules, including US hours and holidays

Role

Team Leader

Timings

Night Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Process

Voice

Functional Area

ITES / BPO / Customer Service

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