Updating Results

Conduent

  • 1,000 - 50,000 employees

PHRN - Nurse Utilization and Clinical Advisor Services Analyst II

Mandaluyong City, Metro Manila
Nursing graduate with PH license, with at least 1-year BPO experience

Opportunity details

Opportunity Type
Graduate Job
Number of Vacancies
1
Start Date
ASAP

Application dates

Applications Close
31 May 2021

Minimum requirements

Minimum Prior Qualification
Certificate
Accepting International Applications
No
Qualifications Accepted
M
Aged Care Nursing
Community Nursing
Critical Care Nursing
Family & Child Health Nursing
Mental Health Nursing
Midwifery
Nursing & Midwifery (all other)

Job Track Description:

  • Requires formal education and relevant expertise in a professional, sales, or technical area.
  • Performs technical-based activities.
  • Contributes to and manages projects.
  • Uses deductive reasoning to solve problems and make recommendations.
  • Interfaces with and influences key stakeholders.
  • Leverages previous knowledge and expertise to achieve results.
  • Ability to complete work self-guided.
  • College or university degree required.

General Profile

  • Requires an understanding of the company, processes, and customers.
  • Uses existing procedures to solve routine or standard problems.
  • Receives moderate guidance and direction from others.

Functional Knowledge

  • Requires expanded conceptual understanding of theories, practices, and procedures. 

Business Expertise

  • Uses an understanding of key business drivers to accomplish work.

Impact

  • Impacts a team, by example, through the quality service and information provided
  • Works within guidelines and policies.

Leadership

  • No supervisory responsibilities.
  • Provides informal guidance to new team members.

Problem Solving

  • Uses existing procedures to solve standard problems.
  • Examines information and standard practices to make judgments.

Interpersonal Skills

  • Exchanges complex information and ideas effectively.
  • Responsibility Statements
  • Applies medical judgment to adjudication of cases/claims.
  • Reviews requests for denial reconsideration and appeals.
  • Manually price and review claims for appropriateness of care or coverage.
  • Works directly with the client to provide input under program policy or procedural requirements.
  • Coordinate with clinical peer reviewers for case/claim resolution.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Additional Information

  • Requires Registered Nurse license in good standing.