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Care Management US RN Data Sr Analyst

Job Location: Manila

Job Number: 1499

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- 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
Qualifications: (1) BS Nursing (BSN) degree or equivalent course (2) Active US State License holder (3) Minimum of 2 years clinical nursing experience is preferred (4) 1 year of customer service or call-center experience and minimum of work experience

Accenture is an equal opportunity employer and welcomes applications from all sections of society and does not discriminate on grounds of race, religion or belief, ethnic or national origin, disability, age, citizenship, marital, domestic or civil partnership status, sexual orientation, gender identity, or any other basis as protected by applicable law.

If you would like to be considered for employment opportunities with Accenture, and need special assistance due to a disability or accommodation for a disability, please call us at 0917.545.9341 or send us an email at careersPH@accenture.com

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