PHRN - Clinical Admin Nurse | Onsite in Makati | Day 1 HMO!

ROLE AND RESPONSIBILITIES

• The Clinical Admin Nurse / Prior Authorization Nurse will require ability to read through clinical information, interpret guidelines and provide recommendation to the physician if medication will not meet criteria for Prior Auth before sending request to Payer. The Clinical Admin Nurse / Prior Authorization Nurse needs to communicate the decision (via phone) to members whether the drug has been approved or denied by Payers. plays a critical role in ensuring centralized, accurate, and timely submission of payer-agnostic prior authorization forms and appeals through prescription benefits, thereby promoting optimal patient care coordination and cost-effective utilization of healthcare resources.

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life’s best work.

JOB QUALIFICATIONS

• Active PHRN License

• Strong Clinical Knowledge base with a minimum of 2 years of Critical Care bedside experience in a tertiary hospital (local/overseas), (areas: ICU, Critical Care Unit, Telemetry, Cardiovascular Intensive Care Unit, Medical Intensive Care Unit, ER)

• Willing to work onsite in Makati

WHAT WE OFFER

• Market Competitive Pay Levels

• Retirement Plan

• Medical Plan (HMO) from Day 1 of employment

• Dental, Medical, and Optical Reimbursements

• Life and Disability Insurance

• Paid Time-Off Benefits

• Sick Leave Conversion

• Tuition Fee Reimbursement

• Employee Assistance Program (EAP)

• Annual Performance Based Merit Increases

• Employee Recognition

• Training and Staff Development

• Employee Referral Program

• Employee Volunteerism Opportunity

• All Mandatory Statutory Benefits

WHO WE ARE

• Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.

• UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.

• We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.

• As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.

• Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together