RN Clinical Consultant — Case Management (Hybrid)

Marsh Agency; Taguig; Hybrid; PHP 800,000 - 1,300,000; Full time

Job summary

MercerWell team at Mercer in the Philippines seeks a Registered Nurse Consultant to guide benefit administrators on opportunities for improved care coordination and case management. This hybrid role requires in-office presence at least three days a week to oversee action plans and ensure accountability.

You will interpret claims data, lead clinical discussions, and craft reports that track outcomes for clients.

Qualifications

• Associate or Bachelor’s degree in Nursing required, with an active, unrestricted U.S. RN or Philippine RN license.
• Minimum of 5 years of relevant work experience in case management, clinical consulting, clinical carrier related experiences (quality assurance, clinical auditing, clinical leadership, stop loss).
• Proven project management, verbal and written skills with strong clinical acumen.
• Ability to analyze clinical data and metrics.

Responsibilities

• Establish effective carrier/vendor relationships with assigned book of business to successfully represent Mercer and to serve our clients.
• Communicate Mercer's point of view on effective clinical management program models and strategies to manage potential and actual high-cost claimants.
• Bring a natural curiosity and continuous quality improvement mindset to evolve and enhance the clinical strategy and delivery of assigned book of business.
• Interpret claims and other data reports leveraging this information to effectively manage assigned book of business.
• Lead case discussions with the benefit administrators' clinical teams to identify strengths and opportunities in how the case is being managed and offer suggestions to shape the course of the member’s care moving forward.
• Synthesize available data, develop engaging reports / presentations, effectively present results to clients in a clear and constructive manner using formats that allow for tracking results over-time to support continuous process improvement.

Skills

Project management

Verbal and written communication

Clinical data analysis

Education

Bachelor’s or Associate’s degree in Nursing

Job description

MercerWell team at Mercer in the Philippines seeks a Registered Nurse Consultant to guide benefit administrators on opportunities for improved care coordination and case management. This hybrid role requires in-office presence at least three days a week to oversee action plans and ensure accountability.

You will interpret claims data, lead clinical discussions, and craft reports that track outcomes for clients.