Responsibilities
Manage and supervise the day-to-day activities of the same day surgery coding teamProvide guidance and support to the team members to ensure that they perform their duties effectively and efficientlyConduct regular performance evaluations of team members to identify areas of improvement and provide feedbackDevelop and implement coding policies, procedures, and best practices that align with industry standards and regulatory requirementsCollaborate with the compliance department to ensure that all coding practices adhere to regulatory guidelines and standardsOversee the coding process, including coding validation, quality control, and review of all coded dataEnsure that all coding is done in a timely and accurate manner to meet established organizational benchmarks and deadlinesMonitor coding productivity and identify opportunities for process improvementStay up-to-date on changes in coding guidelines, regulations, and laws, and provide education and training to the coding team as neededManage the team's work schedule and ensure adequate coverage is provided at all timesServe as a liaison between the coding team and other departments, including the revenue cycle team, clinical documentation improvement team, and compliance department
Qualifications
Bachelor's degree in Nursing or a related field in healthcareAt least 3 years of experience in medical coding, with a minimum of 1 - 2 years of experience in same day surgery codingActive COC, CPC or CCS Certification.Strong knowledge of ICD-10-CM/PCS and CPT coding systems, coding guidelines, and regulationsExcellent leadership and management skills, with the ability to motivate and lead a teamStrong organizational and problem-solving skills, with the ability to multitask and prioritize tasks effectively

The Medical City Clinic is looking for an Analyst – Cash Management in Waltermart Sta. Maria (Bulacan). This role is responsible for reviewing data provided by patients and verifying its accuracy for billing purposes. This role covers tracking and managing patient cash flows, credit, and insurance payments, while also assisting admin associate staff with patient booking and in-clinic coordination.
Duties and ResponsibilitiesA. Operational EfficiencyVerifies patient benefit information and applies the appropriate medical services renderedPrepares itemized statements, bills, or invoices and records amounts due for purchased items or rendered servicesProcesses billing to patients and third-party reimbursement claimsEstablishes payment arrangements with patients when accounts become delinquentHandles and deposits cash, credit, e-payment, and check transactions of customersEnsures accuracy of pricing, issue receipts, invoices or refundManages up-to-date clinic income records by sending and receiving bank checks and documents all relevant transactionCounts money in cash boxes/drawers at the beginning and end of shifts to ensure that the amount is correct and that there is an adequate changeEnsures compliance with the guidelines of the Bureau of Internal Revenue (BIR)Ensures compliance with the guidelines and policies of cash management to minimize audit findingsB. Customer RelationsAssists in managing customer queriesC. Administrative EfficiencyPrepares and generates reports such as but not limited to doctors’ statements of account, monthly, daily cashier, and censusPerforms other tasks that may be assigned from time to time
Job SpecificationGraduate of Bachelor of Science in Business Administration or any related coursePreferably with at least 1–6 months of related work experience in clinical settings

PHRNs who are planning to take the NCLEX soon are also welcome to apply.Join Optum and help make the health system work better for everyone. The US Registered Nurse reviews medical requests to make sure services are medically necessary and aligned with clinical guidelines. This role works closely with doctors, care teams, and insurance partners to support safe, appropriate, and cost‑effective patient care.
Role Overview:You will conduct clinical coverage reviews for services requiring prior authorization. Using evidence‑based guidelines, medical policies, and benefit documentation, you will assess the medical necessity and appropriateness of both inpatient and outpatient services.Your work helps members, providers, and care teams feel confident in the quality and integrity of our clinical decisions—giving you the opportunity every day to do your life’s best work.
Key ResponsibilitiesReview and assess medical requests for authorization (admissions, procedures, treatments)Apply clinical guidelines to determine medical necessityCoordinate with physicians, providers, and care teams for additional information when neededDocument reviews and decisions accurately in the systemEscalate complex cases to Medical Directors when requiredEnsure compliance with healthcare policies and turnaround timesCollaborate with internal teams to support quality patient outcomes
Minimum qualifications:Valid and unrestricted USRN licensePHRN license required; PHRNs planning to take the NCLEX soon are welcome to applyMinimum 2 years of hospital bedside experience, preferably in ICU, ER, Medical-Surgical, and/or Operating Room (OR)Strong clinical judgment and understanding of acute care and care coordination.Proficiency in computer navigation and electronic medical record review.Willing to work onsite during training and hybrid work arrangement post-training
Why Join Optum?Be part of a global organization committed to innovation in health care.Work with diverse clinical teams in a supportive and collaborative environment.Grow your career with extensive learning and development opportunities.Experience meaningful work that directly impacts patient care outcomes.
What we Offer:Market Total Rewards PackageRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
Who We are:Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives.Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together

Job Responsibilities
Answer and resolve technical issues through mostly calls and via chat and web portal at a large corporate Service Desk, efficiently and professionally, in a high volume call center environment that operates 24x7x365Diagnose hardware, software, printing, and network connectivity issues including LAN, WAN, and VPN access in a Windows 10 environment, offering a variety of level 1 to 2 solutions over the phone, via chat or email. Using remote control tools to assist customers when neededAssist end users with their endpoint devices, Contact Center solutions applications, Collaboration application such as WebEx and JabberTroubleshoot corporate applications (MS Office Suite, Tableau, Rightfax, Enterprise supported browsers, Java Plug-ins etc.) with the use of a Knowledge Base and assign issues to the appropriate support group as neededProficiently manage the resolution of inbound technical contacts; balancing customer service, providing support, and issue resolution with the constraints of a call handle time goalEffectively translate complex, technical concepts into easy to understand language to assist non-technically oriented customersDemonstrate a highly developed sense of integrity and commitment to customer satisfactionAccurately, quickly, and efficiently typing record all interactions with customers in an incident management tracking toolAdhere to policies and procedures regarding the safeguarding of protected information, such as personal health information (PHI/PII) and access to corporate systemsEscalate high priority, high impact issues to the internal support teamsAdhere to a strongly regimented schedule (start/end times, lunches, breaks, non-production time, etc.)Meet or exceed statistical metrics regarding; ticket and contact quality, first call resolution, schedule adherence, and call handle timeAnticipates customer needs and proactively identifies solutionsComply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Job QualificationsUndergraduate degree or equivalent experience1+ years of experience the desktop support technology field1+ years working in a high-volume call center environmentIT Helpdesk experience, Desktop/Product Support ExperienceDirect customer service or relationship management experienceProven experience contributing and aligning to a vision and translating that into practical actionMust be willing to work in Makati, Quezon City, Alabang, Cebu or Davao
What we offerMarket Total Rewards PackageRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefit
Who we areOptum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East.This includes our over 25,000 employees in the Philippines. Elevate your career with a leading health care company while improving lives.

As the Clinical Team Supervisor, you will be the frontline leader for a newlyestablished team of Clinical Nurses delivering Medication Therapy Management (MTM)services to US-based Medicare & Retirement (M&R) patients.Reporting directly to the Operations Manager, you will be responsible for the day-to-dayoperational success of your team. Your primary focus will be balancing clinical quality withcontact center metrics, ensuring your nurses are supported as they transition from bedsidepractice to a telephonic BPO environment. You will drive performance, foster a culture ofcontinuous learning, and ensure all services comply with US healthcare standards andorganizational protocols
Key ResponsibilitiesTeam Leadership & Coaching: Manage, coach, and mentor a team of US-licensed Clinical Nurses. Conduct regular 1:1s, performance reviews, and provide constructive feedback to ensure high-quality patient interactions.Operational Performance: Monitor and drive key performance indicators (KPIs) such as schedule adherence, average handle time (AHT), quality assurance (QA) scores, and successful MTM completion rates.Escalation Management: Serve as the first point of leadership escalation for complex patient interactions, technical issues, or workflow roadblocks.Transition Support: Actively guide and support nurses transitioning from local bedside practice into a highly regulated US telehealth setting, ensuring they build confidence in telephonic patient care.Process Improvement: Collaborate with the Operations Manager and SMEs to identify workflow inefficiencies and implement process improvements.Compliance Oversight: Ensure the team strictly adheres to HIPAA regulations, data privacy laws, and MTM clinical guidelines.
Required QualificationsActive PHRN and USRN Licenses - is highly preferredAt least 1–2 years of supervisory or team lead experience within a healthcare BPO, telehealth, or clinical call center environment.2+ years of clinical/bedside nursing experience, providing a strong understanding of disease state management.Proven ability to manage and interpret contact center metrics (SLAs, AHT, QA) and translate data into actionable coaching plans.Ability to work Manila night shifts aligned with US CST hours, with flexibility for extended hours during program ramp-up
What We OfferMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits

Job Responsibilities
People Leadership & Development Provide daily operational leadership and guidance for Manila based Services team members. Conduct regular 1:1s, coaching sessions, and performance check ins to support employee development and engagement. Foster a supportive, consistent, and well coordinated team environment. Operational & SLA Management Assign and balance team workloads, ensuring consistent SLA performance and business continuity. Serve as the firstline escalation point for blockers, prioritization issues, and service quality concerns. Partner with North American team leadership to support seamless customer implementations. HR Process Oversight Manage local HR processes including onboarding, timekeeping, leave tracking, and basic employee relations. Ensure compliance with PH labor policies, workflows, and documentation requirements. Partner closely with HR on approvals, provisioning, and employee support needs. Cross Regional & Stakeholder Collaboration Work closely with US based leadership and cross functional teams to align expectations and support service delivery. Strengthen employee experience through consistent communication, alignment, and operational transparency.
Job Qualifications
People Management (3–5+ years) Demonstrated experience managing and developing teams, ideally supporting IT, technical, or services functions. Proven ability to drive performance, engagement, and growth. Skilled in conducting 1:1s, coaching, performance reviews, and handling team escalations. Operational Leadership Experience overseeing day-to-day team operations, workload distribution, and SLA commitments. Ability to manage escalations, prioritize tasks, and ensure consistent coverage. Strong Knowledge of PH Labor Practices & HR Processes Understanding of timekeeping, leave management, onboarding, basic employee relations, and compliance with Philippine employment regulations. Familiarity with PH vs. US HR process differences is a strong advantage. Communication & Stakeholder Management Ability to partner effectively with crossregional teams (US/NA). Strong written and verbal communication skills; capable of presenting updates, raising risks, and coordinating across time zones. IT / Technical Background (Generalist) Exposure to IT service delivery, project management, or technical operations. Ability to support services teams who work in technical environments.
NicetoHave Skills:Experience working in matrixed organizations. Familiarity with US HR processes. Ability to collaborate with site leadership on operational and people strategies.
What we offer:Market Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
WHO WE ARE:Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.

The Patient Access and Scheduling Specialist serves as the primary point of contact for patients entering the healthcare system. This role is a blend of high-level customer service and technical precision, ensuring that patient demographics, insurance verification, and clinical scheduling are handled accurately to facilitate a seamless care experience.
Key ResponsibilitiesPatient Intake & Registration: Coordinate the end-to-end registration process, including gathering demographic information and obtaining necessary consent forms.Complex Scheduling: Manage high-volume appointment scheduling across multiple clinical departments, ensuring adherence to provider-specific protocols.Insurance Verification: Perform real-time insurance eligibility checks, obtain prior authorizations, and communicate estimated out-of-pocket costs to patients.Financial Counseling: Assist patients in understanding their financial responsibilities and facilitate Point-of-Service (POS) collections.Data Integrity: Maintain the accuracy of the Electronic Health Record (EHR) by identifying and merging duplicate records and updating insurance coverage.Patient Advocacy: Act as a navigator, providing directions, prep instructions for procedures, and resolving scheduling conflicts with empathy.
Required QualificationsEducation: College DiplomaExperience: Minimum of 1–2 years of experience in a healthcare setting (hospital, physician's office, or outpatient clinic)Technical Skills: Proficiency in US Healthcare ProcessCommunication: Exceptional verbal and written communication skills with the ability to remain calm under pressure in a fast-paced environment.
Preferred QualificationsEpic Experience: Highly preferred. Proven proficiency in Epic Prelude (Registration) and Epic Cadence (Scheduling) modules.

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Job Summary: The clinical appeals specialist (PHRN) is responsible for the review, processing, and resolution of appeals cases in compliance with NCQA and, if applicable, CMS regulatory standards and client specific guideline. The role ensures timely and clinically sound appeal determination, upholding member rights and health plan obligations under commercial and CMS regulations. The clinical appeals specialist also supports case documentation, member and provider communications, and contributes to the quality and compliance targets of the payor program.
Essential Duties and Responsibilities:Apply InterQual or MCG (Milliman Care Guidelines) to determine the medical necessity of requested services.Coordinate with healthcare providers to ensure clinical documentation supports the level of care.Maintain high accuracy and productivity standards in a remote, fast-paced environment.
Minimum Qualifications:Education: Graduate of BS Nursing.License: Must possess an active PHRN License.CPO Experience: At least 1 year of solid experience in InterQual or MCG (Milliman Care Guidelines).Clinical Experience: At least 2 years of bedside experience in high-acuity areas:ICU (Intensive Care Unit)CCU (Critical Care Unit)ER (Emergency Room)Tech Requirements: Must have a stable internet connection and a conducive home office setup for a Permanent WFH arrangement.
Why Join Us?Permanent Remote Work setup.Government-mandated benefits and HMO.Opportunities for career growth in the US Healthcare industry.

The Medical City Iloilo is seeking a qualified Infection Control Nurse who will play a pivotal role in preventing and controlling healthcare-associated infections within the hospital. This position is designed to ensure the implementation of effective infection prevention strategies, safeguarding patients, staff, and visitors while supporting the institution’s commitment to clinical excellence and patient-centered care.
What’s the Role All About?Job responsibilities include, but are not limited to:Implement and monitor infection prevention and control programs in accordance with hospital policies and regulatory standards.Conduct surveillance of healthcare-associated infections (HAIs) and analyze data to identify trends and risks.Educate healthcare workers on infection control practices, including hand hygiene, proper PPE use, and isolation protocols.Perform regular infection control audits and inspections across hospital departments.Investigate and report infection outbreaks, and recommend appropriate control measures.Collaborate with clinical teams to ensure adherence to infection prevention protocols.Develop and update infection control policies, guidelines, and procedures.Ensure compliance with local and national infection control standards and regulations.Maintain accurate documentation and prepare reports related to infection control activities.Participate in quality improvement initiatives to enhance patient safety and infection control practices.Who Are We Looking For?An effective Infection Control Nurse must possess the following qualities and skills:Values-Driven Behaviors Demonstrates integrity, accountability, collaboration, and excellence in promoting a safe healthcare environment.Infection Control Expertise Strong knowledge of infection prevention, surveillance, and control practices in a hospital setting.Critical Thinking & Analytical Skills Able to assess infection risks and implement appropriate interventions.Professionalism & Education Effectively educates and influences healthcare staff on best practices in infection control.Collaboration & Communication Works efficiently with multidisciplinary teams to ensure compliance and patient safety.Qualifications:Must be a Registered Nurse recognized by the Professional Regulation Commission (PRC).Preferably with at least two (2) years of hospital experience, ideally in infection control, clinical nursing, or related areas.Training or certification in Infection Prevention and Control is an advantage.Strong knowledge of infection control standards, protocols, and hospital practices.Proficient in documentation, reporting, and MS Office applications.Willing to work in a dynamic hospital environment dedicated to safety and quality care.Join our team and help ensure a safe and infection-free environment for every patient, every staff member, and every visitor.

The Proposal Content and Outreach Analyst is responsible for working with subject matter experts to develop responses to RFP questions where a standard response does not exist and using the developed response to build out the proposal database of standard content (including language and exhibits). Additionally, the analyst is responsible for the ongoing, regular maintenance of the standard content for accuracy and timeliness through scheduled periodic review of materials with the SME. The analyst is responsible for this work based on assigned product and service areas of the organization. The analyst conducts their work through use of the RFPIO proposal database. The analyst also contributes to projects that support the team’s or the overall department’s initiatives.
Responsibilities:Develop and conduct work based on a thorough understanding of RFP and sales strategy documentsBased on assigned products and services of the organization:Ensure proposal content and responses are strategic, persuasive and client friendlyWork within each RFP project’s established timeline to research (via internal SMEs) responses to RFP questions for which a standard response does not existLeverage the newly developed responses to augment the proposal database of standard content through use of strong writing and editing skills Collaborate with SMEs on a regular, ongoing basis to review and update standard proposal contentMaintain a working knowledge of assigned topics and working relationships with SMEs to proactively support the quality and accuracy of proposal responses and standard contentMaintain a comprehensive SME List that supports the analyst’s assigned topicsActively seek and implement ways to make standard content strategic, compelling and competitive in the marketCollaborate with UnitedHealth Group businesses to assure content integrity and message alignment as neededContribute to team knowledge-sharing with internal customers via newsletters and team meetingsUse RFPIO proposal database tool to manage content according to established process and proceduresAct as an involved team member, contributing meaningful suggestions toward team growth, engagement and process enhancementsActively contribute to the team’s success by fully engaging in assigned roles as part of group projects or overall department initiatives
Qualifications:Undergraduate degree or equivalent experience5+ years of proposal-related experience, preferably in the PBM or healthcare arena5+ years of strategic project management experience, including workflow and timeline management, with a strong focus on multiple projectsExcellent written and oral communication skillsExercised critical and analytical thinking skillsProven skills editing proposal contentSelf-start and independent working skillsAttention to detailExperience with Microsoft Office applications and proposal management toolsTime management - adherence to deadlines PreferredContent management experience with RFPIO
What We Offer:Market Competitive Pay LevelsAccessible sites (Makati, Alabang, Quezon City, and Cebu)Retirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
Who We Are:Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives. Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.

Job ResponsibilitiesPartner with cross-functional stakeholders to understand proposed initiatives, scope, timing, and operational implicationsAnalyze operational and workforce data to assess potential impacts to capacity, service performance, and costDefine and document key assumptions, risks, and dependencies tied to proposed changesTranslate business concepts into measurable drivers (e.g., volume, handle time, utilization, service targets)Collaborate with Workforce Planning and Finance to quantify staffing and financial impactsPrepare clear, executive-ready summaries and recommendations to support decision-makingSupport post-implementation reviews to validate projected vs. actual outcomes
Job Qualifications4+ years of experience in Workforce Management, capacity planning, operational analytics, process improvement, or related analytical rolesExperience supporting contact center or back-office operationsStrong analytical skills with demonstrated experience working with complex operational data and performance metricsExperience presenting findings and recommendations to senior leadersAdvanced proficiency in Excel and data analysis toolsAbility to manage multiple initiatives and deadlines in a fast-paced environment
Preferred QualificationsBachelor’s degree in Business, Finance, Economics, Mathematics, Data Analytics, or related fieldExperience in healthcare or regulated industriesExperience working within enterprise planning or forecasting processesFamiliarity with Workforce Management (WFM) platforms such as NICE, Verint, or Aspect
What we offerLaptop/Computer Provided by the CompanyMarket Total Rewards PackageRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
Who we areOptum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East.This includes our over 25,000 employees in the Philippines. Elevate your career with a leading health care company while improving lives.

JOB RESPONSIBILITIESGather, analyze, review, predict, and identify trends in complex data.Provide analysis and interpretation for operational and business review and planning.Support both short-term and long-term operational and strategic business activities through analysis.Develop and implement recommended business solutions based on research and data analysis.Assist with ad hoc operational and strategic business activities through analysis and reporting.Review and report on key operational metrics, including volume, average handle time, shrinkage, occupancy, utilization, attrition, and SLA/turnaround time.
JOB QUALIFICATIONSUndergraduate degree or equivalent experience5+ years Strong exposure to Genesys Dialer (Outbound)Setting up the dialer and also real time throttle managementUnderstanding of WFM planning and real time managementMust be willing to work onsite (Makati, Taguig, Alabang, Quezon City or Cebu)
WHAT WE OFFERHybridLaptop/Computer Provided by the CompanyMarket Total Rewards PackageRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
WHO WE ARECareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.

The Clinical Subject Matter Expert (SME) is the clinical anchor and primaryknowledge resource for our Medication Therapy Management (MTM) program.Working closely with the Operations Manager and Team Supervisors, the SME ensures thehighest standard of clinical accuracy and patient safety. You will serve as the ultimate escalationpoint for complex pharmacological queries, conduct quality audits, and drive continuouseducation. By facilitating peer-to-peer knowledge sharing and updating clinical resources, youwill empower our Clinical Nurses to confidently manage complex medication regimens for US-based M&R patients.Note: This role requires working night shifts in Manila to align with US Central Standard Time(rotating shifts between 8:00 AM and 8:00 PM CST, Monday through Friday).
Key ResponsibilitiesClinical Escalations: Act as the primary resource for Clinical Nurses encountering complex medication profiles, drug interactions, or difficult disease state management scenarios.Quality Assurance & Auditing: Conduct regular clinical audits of patient documentation and recorded calls to ensure strict adherence to the 5 Core Elements of MTM Services and internal quality standards.Training & Nesting Support: Partner with the training team to support new hireonboarding (nesting phase), ensuring clinical concepts are accurately translated intopractical, telephonic workflows.Knowledge Management: Develop, update, and maintain clinical job aids, processflows, and FAQs.Continuous Education: Design and facilitate ongoing clinical upskilling sessions, fostering a culture of employee-generated learning where nurses share unique case studies and best practices.Cross-Functional Collaboration: Work alongside US counterparts and clinicalpharmacists to clarify guidelines and implement new clinical directives from the client.
Required QualificationsActive, unrestricted USRN and PHRN Licenses3+ years of robust clinical nursing experience, with a strong foundation in pharmacology, geriatrics, or chronic disease management.1–2 years of experience in a clinical BPO setting, preferably in a QA, training, or senior clinical role.Deep, demonstrable understanding of Medication Therapy Management (MTM) protocols, Pharmacy Benefit Management (PBM), or Retrospective Drug Utilization Review.Advanced ability to navigate complex EHR/EMR platforms andinterpret prescription claims data.
What We OfferMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits

ROLE AND RESPONSIBILITIESPositions in this function include RN roles (with current unrestricted licensure in applicable state) responsible for providing clinical expertise in any of the following areas: Clinical Interface/Liaison (clinical problem solver with facilities, providers, carriers; resolution of issues concerning members, benefit interpretation, program definition and clarification); Clinical Operations Analysis (monitors and analyzes medical management activities; provides analytical support to clinical programs; may perform clinical assessments and clinical audits); Clinical Training (planning, coordinating, delivering and evaluating clinical training); Clinical Writing (writing nursing tools and reference information to support the design of clinical products and services). Clinical Program Management (development, implementation and/or on-going management and administration of a clinical program(s). Provides strategic oversight and support, measurement standards and revisions as needed for delivery of programs focused on quality, affordability and outcomes.) Manages and is accountable for professional employees and/or supervisors. Impact of work is most often at the local level.
JOB QUALIFICATIONSBachelor’s degree of Nursing + Active USRN License (mainland only)Strong Clinical Knowledge base with a minimum of 2 years of Critical Care bedside experience in a tertiary hospital (local/overseas), (areas: ICU, Critical Care Unit, Telemetry, Cardiovascular Intensive Care Unit, Medical Intensive Care Unit, ER)At least 3 years supervisory/management position BPO HC experienceCase Management exp preferred
WHAT WE OFFERMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
WHO WE AREOptum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives.
Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together

The USRN Senior Operational Trainer drives learning outcomes for healthcare operations by delivering robust clinical and operational training programs aligned to client protocols, regulatory standards, and performance metrics. This role blends clinical expertise with instructional design, facilitation, and coaching, ensuring frontline staff are confident in medication education, drug interactions, call handling, compliance, and documentation. You’ll partner with Operations, Quality, and Client teams to launch new programs, train novice staff, upskill tenured staff, and improve member experience.
Key Responsibilities
Training Delivery & Facilitation Lead new hire and upskill training clinical programsFacilitate onsite instructor-led classroom training with possibility going of hybrid/virtual set upMaintain high engagement using interactive techniques, role plays, case-based learning, and simulationsCoach trainees on call probing, medication health teaching, drug interaction awareness, call flow, documentation standards, and empathetic communication techniques.
Content & Curriculum Development Design and update training materials, microlearnings, job aids, SOP-aligned workflows using PowerPoint and Canva; Articulate 360 (Rise/Storyline) experience is a plus.Partner with Subject Matter Experts MEs (SME) and Quality Auditors A (QA) to convert error trends and Voice of the customer (VOC) VOC insights into targeted learning interventions. Operational Readiness & Performance Impact Conduct training needs analyses and learning diagnostics; propose curriculum improvements and remediation plans.Establish training success metrics; track and report certification rates, nesting performanceon the job training performance, speed-to-proficiency, Quatlity Quality Audit A clinical accuracy, and rework reduction.Support process changes, and cross-skilling initiatives; ensure readiness through checklists, train-the-trainer (TTT), and huddles.
Coaching, On the Job TrainingNesting & Transition to Production and Steady State Run post-training nesting with calibrated side-by-sides, live call monitoring, and targeted coaching plans.Collaborate with Operations and Quality to align on performance goals, call behaviors, and clinical decision standards.Provide floor support during peak or stabilization periods; create reinforcement plans and refreshers.
Compliance, Quality & Documentation Ensure adherence to Health Insurance Portability and Accountability Act (HIPAA), client policies, and company learning standards.Maintain accurate training records, attendance, assessments, evaluation reports, and version control for all materials.Participate in calibration sessions with QAQA/Clinical SMEs to ensure consistency of coaching guidance.
Minimum Qualifications (Must-Haves)Active US Registered Nurse (USRN) license.≥ 2 years of clinical experience (e.g., hospital, ambulatory, case management)Strong knowledge of medication health teaching and drug interactions; able to explain risks, contraindications, side effects, and adherence strategies in layman’s terms.≥ 1 year clinical operational trainer experienceExcellent English communication (verbal & written): clear, concise, and professional.Proven ability to build rapport over the phone with members, providers, and care team stakeholders.Tech-savvy with MS Office/365 (PowerPoint, Word, Excel), MS Teams, and LMS familiarity.Virtual facilitation experience; able to engage learners in online environments.Good typing skills and accurate documentation habits (70+ WPM preferred or program-standard).Experience creating training collateral materials using PowerPoint and Canva.
What We OfferMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits

Position Accountability Statement:Maintains enterprise metadata and lineage documentation to support transparency andcompliance.
JOB RESPONSIBILITIES● Capture and maintain technical and business metadata for enterprise data assetsmaintained by EDM.● Document end to end data lineage across source systems, data pipelines and reportinglayers.● Collaborate with the data governance team to ensure alignment with metadatastandards and definitions.● Work with technical and non-technical data stakeholders to enrich and validatemetadata.● Support impact analysis, change management and regulatory reporting through accuratelineage and documentation.● Assist in building and maintaining the data catalog from an EDM perspective.● Define and document data quality rules for key data elements managed by EDM● Perform data profiling and quality assessment to monitor accuracy, completeness andconsistency● Investigate and escalate data quality issues.● Track and report data quality KPIs and support RCA for recurring issues● Partner with the data governance team to ensure that CDEs are accurately monitored.
EDUCATIONAL REQUIREMENTBachelor’s degree in Computer Science, IT or a related field
Professional Qualification:● Minimum of 3 yrs experience in metadata management, data lineage analysis and dataquality assessment.● Experience with data catalog and lineage tools● Proficient in SQL, data profiling and working in cloud data environments● Excellent problem-solving and stakeholder communication skills.● Familiarity with data governance framework and regulatory requirements● Strong analytical, documentation and stakeholder communication skills.● Can work cross-functionally with governance, technical teams and business teams

Job Responsibilities
The role involves:Work within AWS and Azure cloud network solutions.Utilize PowerShell for automation and network management tasks.Perform integration work to ensure seamless connectivity and interoperability.Monitor network performance and troubleshoot issues.Ensure network security and compliance with industry standards.Provide technical leadership and mentorship to junior network engineers.
Citrix-Specific Duties:Design, deploy, and manage Citrix environments, including XenApp, XenDesktop, and Citrix Cloud.Optimize Citrix infrastructure for performance, security, and user experience.Implement Citrix Profile Management and Citrix Provisioning Services (PVS).Utilize Citrix Director for real-time monitoring and diagnostics.Manage Citrix StoreFront and Citrix Gateway configurations.Conduct regular updates and patch management for Citrix components.Provide advanced troubleshooting and support for Citrix-related issues.Utilize AI tools to improve automation and reporting initiatives, troubleshooting and metrics.
Job QualificationsBachelor's degree in Computer Science, Information Technology, or a related field or commensurate experience.Relevant certifications are an advantage, preferably Citrix-related.5+ years Strong knowledge of Citrix technologies.Hands-on experience with AWS and Azure cloud platforms.Proficiency in PowerShell scripting for network automation.Strong understanding of network security principles and best practices.
What we offerMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
Who we areOptum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 14,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives. Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together.

Qualifications:At least 4-year relevant experience in Onboarding new hires in a Shared Services settingOnboarding - Perform end to end onboarding process, rollout verbal offer, contract creation and pre-employment/statutory requirements monitoring and update, medical exam and Background check completion monitoring and update, and provide onboarding and access management instruction to hiring managersData Management - Update tracker/s and generate reports and Workday ManagementOthers - Act as back-up initial interviewer

PHRNs who are planning to take the NCLEX soon are also welcome to apply.Join Optum and help make the health system work better for everyone. The US Registered Nurse reviews medical requests to make sure services are medically necessary and aligned with clinical guidelines. This role works closely with doctors, care teams, and insurance partners to support safe, appropriate, and cost‑effective patient care.
Role Overview:You will conduct clinical coverage reviews for services requiring prior authorization. Using evidence‑based guidelines, medical policies, and benefit documentation, you will assess the medical necessity and appropriateness of both inpatient and outpatient services.Your work helps members, providers, and care teams feel confident in the quality and integrity of our clinical decisions—giving you the opportunity every day to do your life’s best work.
Key ResponsibilitiesReview and assess medical requests for authorization (admissions, procedures, treatments)Apply clinical guidelines to determine medical necessityCoordinate with physicians, providers, and care teams for additional information when neededDocument reviews and decisions accurately in the systemEscalate complex cases to Medical Directors when requiredEnsure compliance with healthcare policies and turnaround timesCollaborate with internal teams to support quality patient outcomes
Minimum qualifications:Valid and unrestricted USRN licensePHRN license required; PHRNs planning to take the NCLEX soon are welcome to applyMinimum 2 years of hospital bedside experience, preferably in ICU, ER, Medical-Surgical, and/or Operating Room (OR)Strong clinical judgment and understanding of acute care and care coordination.Proficiency in computer navigation and electronic medical record review.Willing to work onsite during training and hybrid work arrangement post-training
Why Join Optum?Be part of a global organization committed to innovation in health care.Work with diverse clinical teams in a supportive and collaborative environment.Grow your career with extensive learning and development opportunities.Experience meaningful work that directly impacts patient care outcomes.
What we Offer:Market Total Rewards PackageRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
Who We are:Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives.Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together

Primary Responsibilities:Design, implement, and govern Microsoft Entra ID configurations, including Conditional Access, MFA strategies, and legacy authentication controls in partnership with Security teamsProvide senior-level technical support and leadership for Microsoft 365 servicesResolve the most advanced escalations from Level 3 support teams, ensuring rapid and effective resolution of complex technical issues and service requestsDesign, implement, and oversee maintenance, monitoring, and administration of Microsoft 365 and on-premises systems to ensure optimal performance, security, and uptimeLead patching, upgrades, capacity planning, security standards, identity design, and architectural reviews to maintain an enterprise-grade, secure, and highly available environmentEstablish and enforce operational best practices, documentation standards, and knowledge sharing across the organizationCollaborate closely with Engineering, Security, Compliance, Infrastructure, and business stakeholders to ensure platforms meet evolving business and regulatory requirementsDrive process improvement and automation initiatives, leveraging advanced PowerShell scripting, Graph API and other automation toolsLead reporting and analysis on key performance indicators (KPIs) for service delivery, operational health, and environmental scalabilityManage and support complex system migrations, integration projects, and enterprise-wide deploymentsProvide technical leadership during major incidents, outages, and critical changes, including root cause analysis, post-incident reviews, and strategic remediationMentor junior engineers and facilitate professional development within the operations team
Required Qualifications:Bachelor’s degree in Computer Science, Information Technology, Engineering, or related fieldRelevant certification and advanced certifications highly desirable (MCSA)5+ years of experience supporting Microsoft 365, Exchange (on-premises and hybrid), and SharePoint (on-premises and hybrid) environments at an enterprise levelAdvanced hands-on experience with PowerShell scripting, automation, and orchestration in Microsoft 365 and Windows Server environmentsExperience managing multiple priorities in a fast-paced, dynamic environmentProven expertise in ITIL incident management, ticket escalation processes, and troubleshooting highly complex technical issuesProven exceptional communication, interpersonal, and organizational skills; proven ability to lead and influence cross-functional teamsExperience with SCCM / ConfigMgr.Exposure to Tanium or similar endpoint management/security platforms.Advanced scripting experience (PowerShell, automation frameworks).Experience working within offshore/onshore delivery models.Understanding of ITIL practices for incident, problem, and change management.
WHAT WE OFFERMarket Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance Based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits
WHO WE AREOptum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.We’re a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.We’re a diverse team with operations across North America, South America, Europe, Asia Pacific and the Middle East. This includes our over 25,000 employees in the Philippines.Elevate your career with a leading health care company while improving lives.
Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that’s dedicated to Caring. Connecting. Growing together