Senior Clinical Program Nurse & Case Manager

Crawford; Iloilo; On-site; PHP 350,000 - 550,000; Full time

Job summary

Crawford in Iloilo, Philippines is seeking a Nurse Case Manager to assess medical records and coordinate proactive case management services. You will analyze case data, define client needs and recommendations to support rehabilitation goals and return to work.

The role requires both Philippine RN licensure and US RN licensure, plus 2+ years of clinical experience or prior medical bill review exposure; strong communication and confidentiality are essential.

Qualifications

• Active Philippine RN license in good standing; US RN license from any mainland state is required.
• Minimum of two years diverse clinical experience or prior Medical Bill Review experience.
• Excellent verbal communication skills and customer orientation.
• Analytical skills to perform bill review per SOP.
• Ability to deliver excellent customer service.
• Active listening and phone handling skills.
• Maintains high degree of professionalism and confidentiality.
• Ability to multi-task, prioritize and manage time effectively.

Responsibilities

• Assess existing medical records to provide proactive case management.
• Analyzes and reviews case records; defines client needs and problems.
• Provide opinions on costs, treatment plan, outcome and rehabilitation goals.
• Interprets medical records and test results for appropriate assessments.
• Reviews cases with supervisor monthly for guidance.
• Performs job site evaluations to facilitate case management.
• Upholds Crawford policies and communicates with internal/external customers.
• Establishes professional relationships with clients and maintains contact on case activity.
• Performs peer reviews and independent medical examination; meets QA targets.
• Handles problem resolution and refers beyond authority when needed.

Skills

Verbal communication

Customer orientation

Active listening

Phone handling

Analytical skills

Multi-tasking

Interpersonal skills

Critical thinking

Education

Bachelor's degree in Nursing

Tools

Word processing software

Job description

Crawford in Iloilo, Philippines is seeking a Nurse Case Manager to assess medical records and coordinate proactive case management services. You will analyze case data, define client needs and recommendations to support rehabilitation goals and return to work.

The role requires both Philippine RN licensure and US RN licensure, plus 2+ years of clinical experience or prior medical bill review exposure; strong communication and confidentiality are essential.