Manager, Medical Management & Care Coordination

Helpjuice; Taguig; On-site; PHP 1,000,000 - 1,800,000; Full time

Job summary

Helpjuice seeks a Manager Medical Management to lead a team of clinicians ensuring high quality, cost-effective member care. You will oversee utilization of inpatient and outpatient services, interpret medical policies, and steer members to appropriate providers and programs. A US RN license and substantial acute care experience are required.

The role emphasizes strong communication, problem-solving, and analytical skills to optimize benefits and resource use across settings.

Qualifications

• Requires current active unrestricted RN license to practice as a health professional within applicable US states.
• Requires 5 years of acute care clinical experience or an equivalent combination of education and experience.
• Strong oral, written and interpersonal communication skills, problem-solving, facilitation and analytical skills.

Responsibilities

• Lead and manage a team of clinicians focused on quality member outcomes, benefits optimization and resource use.
• Ensure adherence to medical policy and appropriate, cost-effective care.
• Coordinate care across facilities/providers, including care coordination and potential appeals handling.
• Hire, train, coach and evaluate performance of direct reports.

Skills

Interpersonal communication

Oral/Verbal communication

Written communication

Problem solving

Analytical skills

Education

RN license (US)

Job description

Helpjuice seeks a Manager Medical Management to lead a team of clinicians ensuring high quality, cost-effective member care. You will oversee utilization of inpatient and outpatient services, interpret medical policies, and steer members to appropriate providers and programs. A US RN license and substantial acute care experience are required.

The role emphasizes strong communication, problem-solving, and analytical skills to optimize benefits and resource use across settings.