Senior Health Care Operations Manager (RN) – Night Shift

Bravissimo Resourcing Inc.

Taguig

On-site

PHP 1,674,000 - 2,344,000

Full time

14 days+

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Benefits offered by this job

Performance Bonus

Incentives

13th Month Pay

Health Maintenance Organization (HMO)

Job summary

A staffing agency is seeking a qualified candidate for a supervisory position based in Taguig, with a focus on overseeing staff and ensuring compliance within the healthcare sector. Ideal candidates will possess at least 12 years of relevant experience, hold a valid US Registered Nurse license, and be familiar with BPO environments. The position offers a night shift schedule and comes with competitive benefits including performance bonuses and government-mandated benefits.

Qualifications

At least 12 years of relevant experience and 10 years of supervisory.</li>
Current and unrestricted US Registered Nurse license.
BPO experience in any account preferred.

Responsibilities

Oversees staff and ensures compliance with medical policy and member eligibility.
Conducts treatment setting reviews.
Handles service requests via inbound calls and facsimile.
Completes review of post-service claims for Medical Necessity or Contractual Reviews.