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Care Management US RN Data Sr Analyst

Keywords / Skills : Nursing, US State License Holder, Registered Nurse, Nurse, Staff nurse

0 - 4 years
Posted: 2019-08-19

Customer Service/Call Centre/BPO
Other Customer Service
Other Information Technology
Other Roles
Posted On
19th Aug 2019
Job Ref code
JC 002
Job Description
Our client, one of the biggest multi-national BPO/IT Company in the Philippines and worldwide, is looking for Care Management US RN Data Sr Analyst.

with 100K signing bonus, we provide license renewal and license endorsement (Territory to Mainland) assistance.

Job Description:
• Responsible in collaborating with healthcare providers and members to promote quality member outcomes, to optimize members’ benefits, and to promote effective use of resources

• Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and may steer members to appropriate providers, programs or community resources

• Work with medical directors in interpreting appropriateness of care 

• BS Nursing (BSN) Degree

• Active US State License holder

• A minimum of three (3) months’ of prior working experience as a Registered Nurse in a clinical setting required:

o Three months is equivalent to 480 hours of working experience as an RN

o Working experience as a Registered Nurse means holding an active RN license and providing direct patient care

o Clinical setting includes inpatient hospital or clinic

About Company

Quess Corp. Ltd., the leading global business services provider firm, was established in 2007. Headquartered in Bengaluru, the company has a pan-India presence with 65 offices across 34 cities along with overseas footprint in North America, the Middle East and South East Asia. It serves over 1700+ customers across 5 segments namely Industrials, Facility Management, People Services, Technology Solutions and Internet Business.

Quess Corp Limited offers an expansive and an impressive set of services across the APAC region with its presence in Malaysia, Sri-Lanka, Philippines, Singapore and Vietnam. We are a step-down subsidiary of USD 44+ Billion (as of 30th Sept 2016), multinational, Fairfax Financial Holdings Group; held through its Indian listed subsidiary, Thomas Cook India Limited. We are committed to providing a world-class customer experience while continuously working towards creating better lives. Superior services and technology solutions have enabled us to achieve market leadership in many of the businesses service lines.
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