Healthcare Member Relations & Utilization Coordinator

iCare HMO; Philippines; On-site; PHP 240,000 - 420,000; Full time

Job summary

iCare HMO is seeking an HMO Coordinator / Member Relations Representative to provide administrative support across Medical Services, Sales and Marketing divisions, and to assist insured members during availments. The role emphasizes effective customer service, utilization management, and strong coordination with hospital networks.

The ideal candidate has a 4-year degree, experience in insurance/HMO, and solid communication skills. Project-based work is possible, with ASAP start.

Qualifications

• Graduate of any 4-year college course; medical allied preferred.
• Experience in insurance/HMO and value-adding services preferred.
• Strong communication, coordination, and negotiation abilities.
• BPO experience handling healthcare accounts is an advantage but not required.
• Open to project-based employment and immediate start.

Responsibilities

• Assist insured members during availments and ensure proper customer service.
• Provide effective administrative support to Hospital Liaison Officers and divisions.
• Perform utilization management tasks, gatekeeping, and case coordination.
• Build rapport with hospitals, providers, and network facilities.
• Assist in accreditation activities and initial claims screening.
• Communicate updates on policies, benefits, and LOA issuances.
• Support scheduling, LOA issuance, and member communications.

Skills

Communication skills

Coordination

Negotiation

BPO healthcare experience

Graduate degree

Education

4-year college degree

Job description

iCare HMO is seeking an HMO Coordinator / Member Relations Representative to provide administrative support across Medical Services, Sales and Marketing divisions, and to assist insured members during availments. The role emphasizes effective customer service, utilization management, and strong coordination with hospital networks.

The ideal candidate has a 4-year degree, experience in insurance/HMO, and solid communication skills. Project-based work is possible, with ASAP start.