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Full-time Email Us Us Rn - Qc Based - One Day Process Ghsjbl

at Global Headstart Specialist, Inc. in Quezon City
Published at Dec 04, 2019

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Job Descriptions:
• Responsible in collaborating with healthcare providers and members
• Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources
• Work with medical directors in interpreting appropriateness of care

Job Qualifications:
• BS Nursing Degree
• Active PRC and US Mainland License
• 2 years of health-related jobs or 1 year BPO Experience plus 1 year health-related jobs

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