DE033033-Health Clinical Services Senior Analyst

Accenture in the Philippines; Taguig; On-site; PHP 600,000 - 800,000; Full time

Job summary

Accenture in the Philippines is seeking a Health Clinical Services Senior Analyst in Taguig for night shift. You will create appeal records for external reviews, draft detailed case summaries, and submit cases to regional teams as directed.

Ideal candidates hold a US RN license and a BSN or equivalent nursing degree, with at least 3 months of clinical experience. Appeals experience is a plus, and the role is based in Uptown Bonifacio Tower, Taguig.

Qualifications

• Active RN license and direct patient care experience.
• Nursing degree or diploma (BSN/GNM/BSc/Associate/Bachelor) required.
• Clinical background in inpatient, outpatient, or community settings.

Responsibilities

• Create complete appeal records for external review using standardized forms.
• Develop detailed narrative case summaries for each appeal.
• Submit cases to respective geographic region as directed.
• Present verbal and written case summaries to Grievance Team and Medical Directors.
• Meet client turnaround times for assignments.

Skills

Active RN license

Patient care

Education

BSN degree

GNM Diploma

Nursing degree

BSc in Nursing

Associate Nursing Degree

Nursing Diploma

Job description

• ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE--- POSITION TITLE: Health Clinical Services Senior Analyst WORK SETUP: RTO OVERALL PURPOSE: RESPONSIBILITIES: Grievance and Appeals Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation. Creates a detailed case summary in narrative format for each appeal. Submits cases as directed for each applicable geographic region. Presents verbal and written case summaries to client’s Grievance Team and client Medical Directors. Completes assignments within client-designated turnaround times. Need to conduct written communication assessments OTHERS: Project Shift Schedule: Night Shift Project Rest Day: Rotation Project/Team Location: Taguig, Uptown Bonifacio Tower 3

• Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma

• Holds current and unrestricted US Registered Nurse license

• 3 months clinical experience (480 hours of working experience as a RN)

• Work experience as an active RN license and providing direct patient care

• Clinical setting includes inpatient hospital, outpatient hospital or community clinic

• No state license required (doability will be revisited if there's a specific state of RN license needed) With at least 3 month UM experience Flex: Open to candidates (without UM experience) with Appeals experience