USRN/ PHRN Team Leader
Job Description
Key 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
• Must not be a current or former employee of Concentrix
Role
Nursing - Critical Care & ICU
Timings
Night Shift (Permanent)
Industry
Health/Fitness/Wellness
Work Mode
Work from office
Functional Area
Medical Professional / Healthcare Practitioner / Technician
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.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
Similar Jobs
4 - 9 Year(s)
150 - 180 Thousand p.m
Manila, Philippines
Operation Manager for Appeals PHRN
Gratitude Inc1 - 10 Year(s)
120 - 150 Thousand p.m
Manila, Philippines
Appeals & Denials Nurse - PHRN
Gratitude Inc1 - 4 Year(s)
40 - 50 Thousand p.m
Manila, Philippines
Health Clinical Services Senoir Manager
Gratitude Inc12 - 15 Year(s)
Confidential
Manila, Philippines
Medicare Grievance Specialist
Gratitude Inc1 - 4 Year(s)
30 - 40 Thousand p.m
Manila, Philippines
Supervisor Health care
Gratitude Inc3 - 5 Year(s)
Confidential
Manila, Philippines
Operation Manager Utilization Management USRN
Gratitude Inc1 - 10 Year(s)
150 - 180 Thousand p.m
Manila, Philippines
Safety Specialist Pharmacovigilance 8FTE
Gratitude Inc3 - 10 Year(s)
40 - 50 Thousand p.m
Manila, Philippines
PHRN – Healthcare Voice Account
Gratitude Inc1 - 5 Year(s)
45 - 55 Thousand p.m
Manila, Philippines

