Deskripsi Pekerjaan
Join MedRisk Philippines' dynamic team as a Non-Clinical UR Coordinator! We're seeking a detail-oriented professional to drive utilization excellence in healthcare delivery. In this critical role, you'll ensure compliance with medical necessity guidelines while optimizing care pathways. Collaborate with interdisciplinary teams to review documentation, analyze treatment plans, and maintain regulatory standards. This opportunity offers career growth in a supportive environment where your analytical skills directly impact patient outcomes and operational efficiency. If you're passionate about healthcare administration and possess strong organizational abilities, MedRisk offers the perfect platform to advance your career.
Tanggung Jawab
- Conduct comprehensive utilization reviews for medical services ensuring compliance with established protocols
- Analyze medical documentation to determine appropriateness of treatments and procedures
- Collaborate with healthcare providers to gather additional information for case resolution
- Maintain accurate records and documentation of all review activities and decisions
- Communicate findings and recommendations to stakeholders through clear written reports
- Stay current with healthcare regulations, policies, and industry best practices
- Support continuous improvement initiatives for utilization review processes
Kualifikasi
- Bachelor's degree in Nursing, Healthcare Administration, or related field
- Minimum 1-2 years' experience in utilization review, case management, or healthcare coordination
- Proficiency in medical terminology and healthcare documentation standards
- Strong analytical skills with attention to detail and accuracy
- Excellent written and verbal communication abilities
- Proficient in Microsoft Office Suite and healthcare management systems
- Ability to work independently and manage multiple priorities in a fast-paced environment