Senior Clinical Program Nurse: Case Management & Rehab

Crawford & Company; Philippines; On-site; PHP 279,000 - 469,000; Full time

Job summary

Crawford & Company is seeking a skilled nurse with case management experience to assess medical records and determine patient needs. The role involves collaborating with clients, evaluating treatment plans, and facilitating return-to-work strategies.

Responsibilities include performing medical reviews, conducting site evaluations, and ensuring compliance with Broadspire policies while maintaining confidentiality and professionalism in all interactions.

Qualifications

• Bachelor's degree in Nursing.
• Active Philippine RN license in good standing; US RN license from any mainland state is a plus.
• Minimum of two years diverse clinical experience or prior Medical Bill Review experience.
• Excellent verbal communication skills and customer orientation.
• Proficient in word processing software applications.
• Analytical skills for basic and complex bill reviews per SOP.
• Strong customer service orientation and active listening.

Responsibilities

• Case Management Services: analyze and review case records, assess medical status, define needs and problems.
• Client Relations: maintain timely communication with clients and inform of case direction or required authorizations.
• Business Process Support: conduct peer reviews and independent medical examinations; meet QA targets; escalate beyond authority when needed.
• Protect confidentiality and adhere to company policies in all communications.

Skills

Verbal communication

Customer orientation

Phone handling

Analytical skills

Multitasking

Attention to detail

Professionalism

Confidentiality

Education

Bachelor's degree in Nursing

Tools

Word processing software

Job description

Crawford & Company is seeking a skilled nurse with case management experience to assess medical records and determine patient needs. The role involves collaborating with clients, evaluating treatment plans, and facilitating return-to-work strategies.

Responsibilities include performing medical reviews, conducting site evaluations, and ensuring compliance with Broadspire policies while maintaining confidentiality and professionalism in all interactions.