Clinical Program Nurse: Case Management & Rehab Coordinator

Crawford and Company; Iloilo City; On-site; PHP 300,000 - 600,000; Full time

Job summary

Crawford and Company is seeking a Nurse case manager to provide proactive management by assessing medical records and coordinating care. The role includes reviewing case records, advising on costs and treatment plans, and communicating policies to clients and partners.

The ideal candidate holds a Philippine RN license (also US license preferred), with at least two years of clinical or medical bill review experience. Strong communication, analytical, and confidentiality skills are essential.

Qualifications

• Bachelor's degree in Nursing is required.
• Active and in good standing Philippine RN license;US RN license from any mainland state also required.
• Minimum of two years clinical experience or prior Medical Bill Review experience.
• Excellent verbal communication and customer orientation.
• Proficient in word processing software.
• Analytical skills for bill review per SOP.
• Ability to deliver excellent customer service.
• Strong listening and phone handling skills.
• High professionalism and confidentiality.

Responsibilities

• Analyze and review case records, evaluate medical status, and define needs and problems.
• Provide opinions on case costs, treatment plans, outcomes, and rehab/return-to-work recommendations.
• Interpret medical records and test results for assessments.
• Review cases with supervisor monthly and obtain directions.
• Perform job site evaluations to support case management.
• Communicate Broadspire policies to internal/external customers.
• Establish professional relationships with clients by timely return to work.
• Maintain contact with all parties involved to update on case activity and direction.
• Meet monthly production and QA requirements; resolve issues independently; refer beyond authority as needed.
• Uphold Crawford Code of Conduct and confidentiality.

Skills

Verbal communication

Customer orientation

Word processing

Analytical skills

Active listening

Critical thinking

Confidentiality

Multitasking

Interpersonal skills

Attention to detail

Education

Bachelor's degree in Nursing

Job description

Crawford and Company is seeking a Nurse case manager to provide proactive management by assessing medical records and coordinating care. The role includes reviewing case records, advising on costs and treatment plans, and communicating policies to clients and partners.

The ideal candidate holds a Philippine RN license (also US license preferred), with at least two years of clinical or medical bill review experience. Strong communication, analytical, and confidentiality skills are essential.