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USRN Data Team Lead

Job Location: Cebu

Job Number: 1593

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- Job description

USRN Team Lead (Non-voice)

Qualifications:
• US Registered Nurse with an active US license
• At least 2 years supervisory experience in any industry
• At least 3 months formal clinical experience
• Experience in Case Management in the health industry a plus
• Willing to work on shifting schedule

Responsibilities:
• Create, implement and manage a program office function in support of the execution of delivery or product work.
• Monitor and report progress to key stakeholders.
• May have responsibilities for the financial and operational management
• Responsible to manage a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources operating in two shifts across the Care Management operation.
• Primary duties may include, but are not limited to: Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective.
• Areas managed may include authorizing 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.
USRN Team Lead (Non-voice) Qualifications: • US Registered Nurse with an active US license • At least 2 years supervisory experience in any industry • At least 3 months formal clinical experience • Experience in Case Management in the health industry a plus • Willing to work on shifting schedule Responsibilities: • Create, implement and manage a program office function in support of the execution of delivery or product work. • Monitor and report progress to key stakeholders. • May have responsibilities for the financial and operational management • Responsible to manage a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources operating in two shifts across the Care Management operation. • Primary duties may include, but are not limited to: Ensures adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost effective. • Areas managed may include authorizing 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.

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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