PH Registered Nurses - Taguig City, NCR

UnitedHealth Group (Taguig, Philippines) 10 days ago

Description

 

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)


Specialty Medical Guidance Program provides prior authorization for utilization management and reporting service to help reduce medical expenses and simplify the provider experience. Caller (either Physician or staff from Physician office) calls the helpline to secure prior authorization for oncology and non-oncology specialty drugs including chemotherapy regimens.


Primary Responsibilities:

  • Take Calls from providers regarding chemotherapy eligibility
  • Take Calls from Providers, or staff from Providers’ Clinic that are requesting Prior Authorization for Specialty Drugs including Chemo Drugs
  • Take Calls from Providers, or staff from Providers’ Clinic that are requesting for status of existing request
  • Outbound Calls during MBMNow outage
  • Make outbound provider calls to complete the down time form
  • Enter the request into the system for the prior authorization after verifying HIPAA
  • Update Basic Information in MBMNow: the system will give the final result either PA approved system approved or need to go through manual review
  • Enter accurate documentation in ICUE/MBMNow
  • Fax via RightFax confirmation page to requesting provider offices

Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so.

Qualifications

 

Required Qualifications:

  • PHRN with active license
  • Minimum 2 years of bedside clinical experience
  • Excellent Communication skills
  • With intermediate skills in Microsoft excel
  • Team player, very good customer service and interpersonal skills
  • Solid clinical acumen
  • Computer literate


Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.


Job Keywords: Philippine Registered Nurse, Nurse, PHRN, PH RN, PH Registered Nurse, Registered Nurse, RN, Taguig City, NCR, National Capital Region

Job Field

  Nursing

PH Registered Nurses - Taguig City, NCR

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