Total 3 Full-time research nurse job vacancies in The Philippines

LOOKING FOR FILIPINO CANDIDATES, RESIDING IN THE PHILIPPINES

Position                   : Utilization Review Nurse

Working Hours       : Monday-Friday: 8:00 AM – 5:00 PM Easter time

Salary                      : $1,200 - $1,400/ month

Job Summary:

The Utilization Review Nurse performs an integral role in our utilization review process by performing record review/case summaries, selection and application of guidelines/literature, quality assurance of physician reviewer reports, and administrative support, including phone and email, for both clinical and non-clinical staff.

Essentials Duties and Responsibilities:

To perform this job successfully, the employee must be able to efficiently and effectively perform each of the following essential functions. Reasonable accommodation may be made for individuals with disabilities.

These duties include but are not limited to:

• Perform all aspects of Utilization Review for Workers' Compensation and group health peer and independent reviews including record summarization and application/interpretation of literature/guidelines. 
• Serve as a liaison between physician reviewer staff and senior clinical leadership.
• Quality Assurance of independent and peer reviews prior to client-side submission.
• Assist the Case Analyst in times of high volume or coverage with administrative tasks such as phone or email support. 
• Language Skills: Ability to read, analyze, and interpret common scientific and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory and governmental agencies, attorneys, or members of the business community.  Ability to write letters, memos and reports that conform to prescribed style, format and grammatical correctness. Ability to effectively present information to top management, in claims and client settings. Strong written and verbal communication skills to effectively communicate with injured workers, medical professionals, employers, claims staff and others. 
• Math Skills: Ability to calculate percentages and statistics in compiling quality management reports.  Ability to convert statistical information into appropriate graphs for data analysis.
• Reasoning Skills: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical and/or clinical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Must have strong organizational, problem solving and time management skills. Sound professional judgement.

• At least 2 years of experience as a Workers Compensation Utilization Review Nurse in a US setting is required
• Must be a registered nurse in the Philippines; USRN licensed is a plus
• Ability to research relevant literature 
• Proficiency with Microsoft Office programs 
• Strong oral and written communication skills
• Strong statistical skills for compiling and presenting data
• Understanding and ability to apply quality assurance concepts

About the company

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®. 

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.   

About the role 

The Registered Nurse (RN) Case Manager is a key member of a cross-functional care team, driven by their mutual devotion to serve others. Members view Case Managers as their patient care guides, advocating for them during some of the most challenging times of their life—facing catastrophic illness, injury or acute and chronic medical conditions. The Case Manager’s clinical expertise and integrated health approach provides each unique patient with education and guidance as they navigate the complexities of health care.

What you’ll bring 

• Education: Bachelor of Science in Nursing (BSN) preferred. 
• Certification: Active Certification in Case Management (CCM) preferred. 
• Experience: 2+ years of clinical experience with direct patient care required; 5+ years preferred.  
• Experience in case management/coordination of programs and services preferred. 
• Excellent verbal and written communication skills. Comfortable communicating with members and providers via phone regularly throughout the day. 
• Ability to communicate effectively with members and providers in implementing clinical services; Translate complex clinical concepts for non-clinical audiences.  
• Strong administrative/technical skills; Comfort working on a PC using Microsoft Office (Outlook, Word, Excel, PowerPoint), IM/video conferencing (Teams & Zoom), and telephones efficiently. 
• Trustworthy and accountable behavior, capable of viewing and maintaining confidential information daily. 

USD 1,200/month

** LOOKING FOR FILIPINOS OR PHILIPPINES - BASED CANDIDATES ONLY **

Position : Research Assistant

Working Hours : TBD/Flexible work schedule; 40 hours/week

Salary Range : 800-1000 USD/month

Holiday : TBD

About the job:

We are seeking a dedicated and experienced Research Assistant to join our team. This role will work closely with the management and help with day-to-day operation activities.

Duties and Responsibilities:

• Help profile and capture online information on individuals who I believe would be prospective clients for my firm.
• Every week I share a list of 50-100 names to the VA, with some basic identifying information on each prospect, enough for the VA to get a start...
• The VA creates a folder structure to hold pdfs, photos, markdown files.
• The VA researches each prospect extensively, to include: full legal name, wealth indicators, residence, social media, background, education, professional employment, biography, family ties, political donations, charitable causes, civic causes, etc...
• The VA records this data into the markdown file (text file) inside the folder (I'll have very specific instructions to follow).  Simultaneously, the VA captures relevant pdfs of websites and other relevant information within the folder.
• The VA shares back the 50-100 prospect folders to me at the end of the week
• Repeat the process weekly...

Qualifications:

• This person needs to be an expert at Google search, writing, and organizing information according to a specific prospecting process, and capturing and recording the information according to file templates, folder structures, etc.
• Preference for Mac operating system (shortcuts, apps, et al)
• Knowledge of markdown formatting (pretty easy to learn)
• High level of English proficiency, both written and verbal

Client Assessment: Client will ask candidates to create and follow the Loom video the client will be sending over; have the candidates take the assessment first before client interview.