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Assistant Manager at EXL Talent Acquisition Team

Pasay, Metro Manila, Philippines -

Full Time

Start Date

Immediate

Expiry Date

20 Sep, 26

Salary

0.0

Posted On

22 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Review, Team Management, Operational Monitoring, Medical Necessity Review, Clinical Review, Performance Reporting, SLA Management, Transaction Monitoring

Industry

Business Consulting and Services

Description

In charge of managing 15 or more Utilization Review team Monitors daily operational tasks of her span and provides support when needed. Also able to do UR work when needed. (In charge of reviewing Medical necessity of medical procedures and treatments and may require decision making for UR claims. May require outbound calls to doctors or providers in case of missing documents that would be needed in the review. Initial Clinical Reviewer is allowed to make certifications and coordinate with Peer Reviewer for any Non-certifications.)

Responsibilities

Manage a Utilization Review team of 15 or more members, monitoring daily operations and ensuring deliverables meet SLA targets. Perform clinical reviews of medical necessity and coordinate with peer reviewers for certifications.