Clinical Admin & Care Coordination Specialist

Optum Philippines; Manila; On-site; PHP 335,000 - 536,000; Full time

Job summary

Optum Philippines is seeking a patient-focused healthcare customer service professional to join our high-volume clinical support team in Manila.

You will manage member intake, coordinate with hospitals and clinics, and handle referrals and authorizations while following company policies. Evening shifts may be required to support members and providers.

A healthcare BPO background and a 1+ year track record will help you succeed, with opportunities to grow within UnitedHealth Group's global network.

Qualifications

• Graduate of any Medical Allied Course or a 4-year degree with healthcare BPO experience.
• 1+ year of Healthcare BPO experience, willing to work at the Muntinlupa site.
• Strong communication and multi-tasking in a high-volume environment.

Responsibilities

• Manage administrative intake of members
• Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
• Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
• Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
• Handle resolution/inquiries from members and/or providers
• Comply with all applicable Company policies, procedures, and business directives, including any changes relating to work location, team assignments, work schedules, and flexible work arrangements.

Skills

Healthcare BPO

Call Center

Customer Service

Education

Medical Allied Course

4-year degree

Job description

Optum Philippines is seeking a patient-focused healthcare customer service professional to join our high-volume clinical support team in Manila.

You will manage member intake, coordinate with hospitals and clinics, and handle referrals and authorizations while following company policies. Evening shifts may be required to support members and providers.

A healthcare BPO background and a 1+ year track record will help you succeed, with opportunities to grow within UnitedHealth Group's global network.