National Capital Region City Jobs Usrn Analyst | Hybrid Work Arrangement! Position at Accenture

Image Accenture
  • Job vacancies posted on: 6 months ago

We are hiring for the position of USRN Analyst | Hybrid Work Arrangement! (EH 1955) with full time working hours for our company office, Accenture, for residents of National Capital Reg and its neighboring areas.

Candidates with expertise in Healthcare & Practitioner/Medical Asst and at least a Bachelor's/College Degree, Post Graduate Diploma/Master's Degree & Professional License (Passed Board/Bar/Professional License Exam) or higher are highly needed. The candidates criteria we are looking for must be trustworthy and disciplined, because our business values a professional and competitive work environment.

Our company provides a competitive salary range of ₱16,000 - ₱38,000, which can be adjusted at the discretion of HRD in our company. This range naturally varies depending on how proficient the candidate credibility can be offered.

We are pleased to announce that our company, Accenture, is currently open recruitment for candidates who are interested in joining our office company as a USRN Analyst | Hybrid Work Arrangement! (EH 1955).

Be without limits! Explore career opportunities and stride success in a team that values all exceptional women!

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Duties and Responsibilities:

  • Conduct UM pre-service, concurrent, retrospective, out of network, and appropriateness of treatment setting.
  • Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
  • Utilize client specific criteria sets (e.g., Milliman or InterQual), applicable client specific medical policy and client clinical guidelines for decision making to either approve or summarize and route to Client’s nursing reviewer and/or Client’s medical staff for review.
  • Accurately routes cases to client medical staff for further review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
  • Responsible for conducting medical management review activities which require the review of clinical information against client specific criteria as noted above but excludes denial determinations.
  • Ensure member access to medically necessary, quality healthcare in a cost-effective setting according to contract.
  • Consult with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
  • Collaborate with providers to assess members, needs for early identification of and proactive planning for discharge planning.
  • Facilitate member care transition through the healthcare continuum and refer treatment plans/plan of care to clinical reviewers as required.
  • Determine contract and benefit eligibility; obtain/confirm intake (demographic) information from callers and/or faxes.
  • Conduct a thorough radius search in “Provider Finder” and follow up with provider on referrals given; refers cases requiring clinical review to a nurse reviewer.
  • Process incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for pre-certification and/or prior authorization. Verify benefits and/or eligibility information. Check benefits for facility-based treatment.

Qualifications:

  • Graduate of Bachelor of Science in Nursing (BSN)
  • Must have an active, unrestricted United State (US) registered nurse license
  • Must have at least three (3) months of prior working experience as a registered nurse in a clinical setting
  • Hybrid Work Set-up, but must be amenable to report in the office as needed

How to apply?

  • Click on “Apply Now” to submit your application.
  • In adherence to Accenture’s process of Identity Verification, your resume or CV must include your photo to ensure the accuracy of your application and during your interviews, a snapshot of your image will be captured for the same purpose.
  • For faster processing of your application, please make sure to have your latest NBI clearance ready. For successful candidates who worked with previous employers, please prepare your approved resignation letter, SSS employment history and Statement of Account. Your recruiters will also remind you of other requirements you can prepare ahead of time.

Why join Accenture?

  • Competitive salary package, company bonuses, and performance incentives
  • Night differential
  • Loyalty, Christmas gift, Inclusion and diversity benefits
  • Paid sick and vacation leaves
  • Expanded maternity leave up to 120 days*
  • HMO coverage (medical and dental) from day 1 of employment
  • Life insurance
  • Employee stock purchase plan
  • Retirement plan
  • Flexible working arrangements
  • Accessible locations
  • Healthy and encouraging work environment
  • Career growth and promotion opportunities

*Terms and conditions apply

Office/Company Address

Country Philippines
Region National Capital Region
Map Google Map

Benefit

  • Get work experience
  • Bonus for overtime
  • Be taught first
  • Good work environment

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Company Description

Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations. We help organizations maximize their performance and achieve their vision. We develop and implement technology solutions to improve our clients’ productivity and efficiency — and may run parts of their operations on their behalf. Ultimately, we enable our clients to become high-performance businesses and governments. With approximately 442,000 people serving clients in more than 120 countries, Accenture drives innovation to improve the way the world works and lives.

RECRUITMENT CENTERS

Manila

· GF Robinsons Cybergate Tower 1, Pioneer Street corner EDSA, Mandaluyong City

Monday - Friday | 9AM-5PM

· GF Plaza B Building, Northgate Avenue, North Cyberzone, Filinvest Alabang, Muntinlupa

Monday - Friday | 9AM-5PM

Ilocos

· Valdez Building A, Venvi IT Hub, Barangay 1 San Nicolas, Ilocos Norte

Monday - Friday | 9AM-6PM

Cebu

· 16F Ebloc2, Geonzon Street, Cebu IT Park, Cebu City

Monday - Friday | 9AM-4PM

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Twitter.com/accenturejobsph

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LinkedIn: Accenture Careers in the Philippines group

Accenture is an equal opportunities 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.

For interested applicants please click “APPLY NOW” and be sure to upload your updated CV or resume through Jobstreet.

Company Info

  • Industry: Call Center/IT-Enabled Services/BPO
  • Company Size: More than 5000 Employees
  • Average Processing Time: 12 days
  • Benefits & Others: Dental, Miscellaneous allowance, Medical, Loans, Business (e.g. Shirts)
This vacancy is suitable for those of you who live in the following areas: National Capital Region