Operations Manager – Utilisation Management
Gratitude IncOperations Manager – Utilisation Management
Job Description
Key Skills
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Job Title: Operations Manager – Utilisation Management (USRN)
Location: On-site – Bridgetowne, Quezon City
Shift: Night shift (US hours), fixed weekends off
Salary Range: ₱150,000 – ₱180,000 (depending on experience)
Start Date: December 31, 2025 or ASAP
Work Setup: 100% On-site
We are looking for an experienced Operations Manager with an active USRN license to lead a Utilisation Management team focused on medical necessity reviews, clinical denials, and appeals for pre-service, concurrent, and retrospective cases in a healthcare/BPO environment.
Key Responsibilities:
Oversee end-to-end UM operations and ensure full compliance with SLAs, HIPAA, and all regulatory requirements
Drive continuous process improvement and operational efficiency
Manage team leaders/supervisors, monitor performance, and handle resource allocation & staffing
Act as the primary point of contact with stakeholders to maintain service quality and accuracy
Implement and monitor quality standards and clinical guidelines utilisation
Minimum Qualifications:
Active and valid US Registered Nurse (USRN) license
At least 1–2 years of managerial experience directly handling Team Leaders/Supervisors
Proven experience managing teams that perform Utilisation Management and clinical denials/appeals
Strong working knowledge of MCG, InterQual, NCQA, and/or ODG guidelines
Excellent English communication skills (verbal and written)
Willing to work fully on-site in Bridgetowne, Quezon City, on night shift (US hours), including holidays when needed
If you are a hands-on leader with solid Utilisation Management operations experience and ready to take on a high-impact managerial role, we want to hear from you!
How to Apply:
Send your updated CV to david.abulu@gratitudeindia.com or through DM.
Only shortlisted candidates will be contacted for the 2-round virtual interview process (Operations + possible assessment).
Role
Operations Manager
Timings
US-Type Shift (Permanent)
Industry
BPO
Work Mode
Work from office
Process
Voice
Functional Area
ITES / BPO / Customer Service
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
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