Senior Clinical Denials Program Lead

TASQ Staffing Solutions; Quezon City; On-site; PHP 2,000,000 - 2,800,000; Full time

Job summary

TASQ Staffing Solutions is seeking a Program Manager – Clinical Denials to lead strategic and operational efforts across clinical denial programs for multiple clients. The role focuses on improving reimbursement, reducing denials, and strengthening revenue cycle performance.

You will oversee cross‑functional teams, establish governance, and translate denial data into enterprise‑level solutions. The position is onsite, night shift, with a six‑month transfer from BGC/Taguig to Bridgetowne, QC.

Qualifications

• Bachelor’s degree in nursing, healthcare administration, HIM, or related field.
• Active RN license or applicable clinical credential.
• 7+ years of healthcare experience with clinical denials, CDI, RCM, utilization management, appeals, or reimbursement.
• 3+ years of progressive leadership/management experience.
• Experience managing large-scale programs, multiple teams, or complex client engagements.
• Strong understanding of inpatient DRG, medical necessity, level of care, clinical validation, coding, reimbursement, and payer policies.
• Demonstrated financial and analytical acumen.
• Excellent executive communication, presentation, negotiation, and stakeholder-management skills.

Responsibilities

• Develops and executes the strategic roadmap for clinical denial management programs.
• Establishes program goals, KPIs, governance structures, and performance standards.
• Oversees multiple teams, managers, and/or client programs.
• Ensures alignment between clinical denial strategy and organizational revenue cycle objectives.
• Develops standardized operating models, workflows, and best practices.
• Owns program-level denial recovery and financial performance.
• Monitors revenue opportunity, recovery rate, and denial inventory; identifies automation opportunities.
• Provides subject‑matter leadership for complex denial categories; partners across CDI, HIM, coding, utilization management, finance, and billing.

Skills

Leadership

Stakeholder management

Communication

Clinical denials

RCM

Utilization management

Appeals

Payer policies

Epic

Payer portals

Denial analytics

BI platforms

Education

Bachelor’s degree in nursing, Healthcare Administration, Health Information Management, or related field

RN license or applicable clinical credential

Tools

Epic

Payer portals

Denial analytics

BI platforms

Job description

TASQ Staffing Solutions is seeking a Program Manager – Clinical Denials to lead strategic and operational efforts across clinical denial programs for multiple clients. The role focuses on improving reimbursement, reducing denials, and strengthening revenue cycle performance.

You will oversee cross‑functional teams, establish governance, and translate denial data into enterprise‑level solutions. The position is onsite, night shift, with a six‑month transfer from BGC/Taguig to Bridgetowne, QC.