PHRN Team Lead (Prior Authorization) Experience | Pasig | Onsite

Omega Healthcare Management Services Inc.; Pasig; On-site; PHP 450,000 - 750,000; Full time

Job summary

Omega Healthcare Management Services Inc. in Pasig, Metro Manila, is seeking a Nursing leader with 3+ years in BPO/Healthcare, focused on utilization management and medical review. The role requires PHRN licensure, 2+ years of US Healthcare team-leading experience, and strong InterQual knowledge.

Responsibilities include training, performance monitoring, process improvement, and daily team leadership. The position is on-site in Pasig, offering opportunities to optimize operations and collaborate

Qualifications

• At least 3 years in the BPO/Healthcare field with exposure to utilization management and medical review.
• Bachelor’s degree in Nursing with an active Philippine Registered Nurse license.
• Minimum of 2 years in Team Lead roles on a US Healthcare account, preferably in Utilization Review/Case Management.
• Strong knowledge of InterQual criteria and utilization management processes.
• Excellent leadership and interpersonal skills.
• Proven ability to drive process improvement and performance optimization.

Responsibilities

• Monitor Nurses’ activities to assess schedule adherence, accuracy, quality, productivity, timeliness, and compliance with policies and procedures.
• Provide basic on-the-job training for direct reports and serve as a resource for policies and processes.
• Supervise day-to-day team functions, including work allocation and attendance monitoring; provide input for hiring, training, development, and performance appraisals.
• Communicate all process and client updates to direct reports within timelines and maintain documentation.
• Escalate performance concerns to Managers in a timely manner, including PIP management.
• Handle employee separations per HR guidelines.
• Conduct daily team briefings and act as a single point of contact for the team.
• Identify and address training needs and complete client-related training.

Skills

Team Lead

Nursing

InterQual

Utilization Management

US Healthcare

Process Improvement

Education

BS Nursing (PHRN licensed)

Job description

About Omega Healthcare

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) is an AI-driven healthcare solutions company that partnersacross the healthcare ecosystem to deliver breakthrough resultsby reimagining and elevating revenue operations.Powered by the Omega Digital Platform®, our agentic AI engineleverages adaptive intelligence to drive automation, complemented by deep human expertise to help optimize performance and deliver sustained financial and clinical outcomes—while enhancing patient satisfaction.

Omega Healthcare empowers organizations across provider, payer, and life sciences sectorsto navigate today’s healthcare challenges while building the agility to adapt as healthcare and technology continue to evolve rapidly.Recognized by industry analysts, Omega Healthcare has consistently been ranked a leader in driving operational performance excellence.

Duties & Responsibilities

• Monitor activities of Nurses to assess schedule adherence, accuracy, quality, productivity, timeliness, and compliance with job requirements, policies, and procedures; provide regular updates to management.

• Provide basic on-the-job training for direct reports and serve as a resource for questions related to policies, processes, and procedures.

• Monitor, identify, and resolve performance, behavior, and attendance issues using prescribed performance management techniques.

• Ensure adherence to all company policies and procedures.

• Adjust to meet service level agreements under the supervision of the Manager.

• Identify and address training needs of team members.

• Complete all client-related training and maintain accurate training records.

• Conduct daily team briefings.

• Communicate all process and client updates to direct reports within specified timelines and maintain documentation of such communications.

• Act as a single point of contact for assigned team members, fostering a positive and collaborative work environment.

• Escalate performance-related concerns to Managers in a timely manner, including PIP management.

• Supervise day-to-day team functions, including work allocation and attendance monitoring; provide input for hiring, training, development, and performance appraisals in compliance with company policies.

• Handle employee separations in accordance with company policies and HR guidelines.

Qualifications

• At least 3 years of experience in the BPO/Healthcare industry, with exposure to utilization management, medical review, and healthcare operations.

• Bachelor’s Degree in Nursing with an active Philippine Registered Nurse (PHRN) license.

• Minimum of 2 years of Team Lead experience in a US Healthcare account, preferably supporting Utilization Review, Prior Authorization, Case Management, or Clinical Operations.

• Strong knowledge of InterQual criteria, utilization management processes, and medical necessity reviews.

• Excellent leadership and interpersonal skills.

• Strong process management and planning capabilities.

• Ability to adapt to change and think operationally to meet business goals.

• Proven experience in process improvement and performance optimization.