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Clinical Healthcare BPO ConsultantSutherland • Taguig, Metro Manila, Philippines
Clinical Healthcare BPO Consultant

Clinical Healthcare BPO Consultant

Sutherland • Taguig, Metro Manila, Philippines
19 days ago
Job description
Job Description

*For Pooling Purposes*

  • Provide consultancy services to the insurance and healthcare vertical to set up the clinical/bill review/insurance practice.
  • Establish and maintain communication with clients and/or team members; understand their needs, resolve issues, and meet their expectations.
  • Participate in RFPs, client proposals, client meetings & sales calls as directed by the supervisor.
  • Produce solid and effective strategies based on accurate and meaningful data reports and analysis and/or keen observations that would impact business outcomes.
  • Identify the training needs that will equip the staff with fundamental skills and knowledge for the clinical/bill review/insurance programs.
  • Have a thorough understanding of the various system tools and operational procedures utilized within the program and provide guidance/recommendations to the operations team on improving service delivery/outcomes.
  • Collaborate with stakeholders on a regular basis for creating strategies.
  • Conduct all defined and required process compliance and adherence to all team members, partners, and third-party providers for clinical insurance program and provide recommendations to improve the framework/rectify the identified gaps.

Qualifications

  • Earned a bachelor’s degree in any related field.
  • Registered Nurse (PH & US Licensed).
  • At least 15 years of work experience in the same industry with 2-3yrs of Director experience.
  • Proven experience in the healthcare/casualty/worker's compensation domain managing processes such as Intake, Clinical Utilization Review, Nurse Reviews, Medical Provider Call Center.
  • Excellent working knowledge on Microsoft Office applications.
  • Ability to efficiently manage time and keep track of multiple schedules, meetings, and initiatives.
  • Strong analytical skills.
  • Demonstrated leadership skills.


Additional Information

All your information will be kept confidential according to EEO guidelines.

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Clinical Healthcare BPO Consultant • Taguig, Metro Manila, Philippines

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