9 Clinical Lead jobs in the Philippines

Work Setup: Onsite (QC)

Certification:  Active CPC, COC, CCS-P, CCS, CIC

Educational Attainment:  Bachelor's degree in nursing or a related field (medical allied courses). Advanced degrees or certifications may be preferred.

Responsibilities:

• Supervise and coordinate the daily activities of the medical coding team to ensure timely and accurate coding of medical records.
• Review and audit coded data for accuracy, completeness, and compliance with official coding guidelines and payer requirements.
• Provide expert guidance on complex coding issues, including DRG change resolution, ICD-10-CM, ICD-10-PCS, CPT coding, and modifier usage.

Requirements:

• 4 years in IP or SDS coding
• At least 2 years of team management experience

Primary Responsibilities:

• Establishes training strategies and approaches

• Demonstrates knowledge of the business environment and business requirements

• Collaborates with internal/external business partners using a consultative approach to identify business goals and performance gaps (e.g., leadership, Human Capital, external customers, Vital Signs)
• Manages the assessment of performance gaps to drive identification of the business need
• Identifies the root cause of performance gaps and the role of training in addressing them, if any
• Identifies non-training solutions to address business needs/performance gaps, where appropriate (e.g., organization design, leadership development, change management, team dynamics)
• Evaluates learner readiness to tailor planning of training solutions
• Translates business needs into training/development needs
• Identifies/selects appropriate training methodologies and communicate to stakeholders (e.g., leadership, training staff, business partners), in order to drive adoption

• Leverages all relevant training/development approaches (e.g., learning from experience, learning from others, learning from education)

• Identifying and maintaining training best practices and trends

• Identifies current and emerging trends in the training industry (e.g., using Corporate Leadership Council, gOEbase, ASTD, SHRM, eLearning Guild, ISPI)

• Maintains knowledge of current and planned technology capabilities in the business
• Maintains awareness of a variety of training delivery modes (Instructor-Led, Computer-Based, blended, webinar)
• Maintains knowledge of new/emerging learning techniques/technologies (e.g., video conferencing, video streaming, social media, mobile, gaming)
• Contributes ideas to influence the adoption of technology solutions that enhance training outcomes in the business
• Comply 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

Required Qualifications:

• Registered Nurse or Med Allied Professional
• Coding Certification
• At least college graduate
• 5+ years of experience in Training / Facilitation
• 2+ years of supervisory experience in BPO healthcare accounts

We are expanding our teams across E-commerce, Retail, Support & Leadership, and Healthcare verticals and are looking for driven professionals to join us.

Work Arrangement: 100% Onsite (Cebu City – IT Park, Tech Tower, Central Bloc)

Start Date: ASAP (some roles starting October 6)

Type of Support: Voice / Non-Voice (depending on role)

• Real Time Analyst (RTA) – Up to 20K package

• 1+ year exp. in RTA role, preferably retail domain

• Knowledge in Verint/IEX/Genesys & MS Excel

• QA Analyst (2 Roles) – Up to 34K package

• 2+ years QA experience in BPO (Retail preferred)

• Strong communication & analytical skills

• Trainer (2 Roles) – Up to 34K package

• 1+ year experience as Trainer (Retail background preferred)

• Strong facilitation skills; demo presentation required

• Team Lead (Retail) – Up to 34K package

• 2+ years leadership experience (Retail preferred)

• Finance Controller Lead – Up to 43K package

• 1–3 years relevant exp., PEZA reporting knowledge

• Asset monitoring experience preferred

• Sales Team Lead – Up to 34K (negotiable)

• 2+ years sales team leadership

• Strong knowledge of KPIs, sales scripts & closing techniques

• Sales Coach – Open Salary

• 1+ year coaching/training experience in sales environment

• Expertise in coaching for quota-based KPIs, objection handling

• Quality Analyst (Sales Domain) – Up to 34K package

• 2–4 years QA/coaching exp. in call center sales domain

• Process Excellence Consultant – Up to 68K package (negotiable)

• 7+ years BPO/healthcare exp. with 3+ years in QA/process improvement

• Six Sigma/Lean/Root Cause Analysis expertise preferred
• Team Lead (Healthcare) – Up to 34K package

Company Description
WNS (Holdings) Limited (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+ global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. WNS South Africa has been in operation since 2003 and built a reputation as the industry leader for Business Process Outsourcing (BPO) in South Africa, with a growing footprint into Africa. We are a strategic partner for delivering a full range of basic to complex processes from our eight delivery centers across South Africa, employing 4000+ people.

Why join us?We promise our employees to experience role clarity, coaching and mentoring, professional development and structured career path through our 5 people promises and keeping employee experience at the core. Experience the culture of outperformance, engagement, celebration and also contribute to society through our WNS Cares Foundation, where you have the opportunity to support meaningful initiatives and make an impact in the community.

Job Description

• Must have good problem solving, decision making & analytical skills.
• Manages team performance.
• Provide effective coaching and constructive feedback to subordinates.
• Performs administrative tasks for Operational support.
• Lead teams into achieving metric goals, complete monthly deliverable and tasks

Qualifications

• Completed at least 2 years in college
• Must have at least 2 years of relevant experience
• Preferably with experience handling Healthcare accounts

Additional Information
Benefits and Company Perks:

• Structured career path
• Growing and expanding team – more internal career progression opportunities for all
• Safe work environment
• Free HMO coverage from day 1, including your domestic partner
• Skills training opportunities
• Paid leaves
• Annual appraisal

What Clinical Operations Management contributes to Cardinal Health

Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.

Clinical Operations Management is responsible for strategic oversight and leadership direction within the Clinical Operations function.

Job Summary

The Director, Clinical Ops Management is responsible for the effective management of one or multiple Cardinal Health programs. This job is responsible for the financial performance of programs and also that operations are compliant with all organizational and regulatory guidelines. The Director, Clinical Ops Management works closely with manufacturers to ensure timely distribution to customers and the successful treatment of patients. This job oversees all activities related to program operation including customer support, IT and analytics.

Responsibilities

• Manages and is responsible for the performance of clinical operations programs, including meeting financial revenue and profit objectives.
• Leads large program team(s) in all functions including Operations, Quality, Production, Data Analytics, Customer Service and Nursing.
• Negotiates contracts on behalf of the organization with potential and existing customers.
• Oversees the activities of the Key Account Managers and Client Relationship Managers to ensure sales objectives and customer service levels are being met.
• Ensures the completion of quarterly business reviews with all customers related to managed programs.
• Maintains compliant operations and ensures the site is prepared for unexpected audit activity or visits from regulatory agencies.
• Collaborates with IT to improve upon product offerings by making adjustments to existing products and prioritizing technology improvement activity.
• Analyzes program data to generate routine and custom reports for internal use and for distribution to program customers.
• Performs special projects as needed to support business needs.

Qualifications

• 12+ years of experience, preferred
• 10+ years proven health care management experience, preferred
• 3+ years as a Director, preferred
• Individuals with a BSN and RN license, strongly preferred
• Previous working experience in physician offices or related US healthcare organizations with rheumatology, oncology, urology, or other therapeutic areas an advantage
• Knowledge of US health-care related computer applications including practice management systems, electronic health record systems, etc. an advantage
• Bachelor's degree in related field, or equivalent work experience, preferred

What is expected of you and others at this level

• Provides leadership to managers and experienced professional staff; may also manage front line supervisors
• Manages an organizational budget
• Develops and implements policies and procedures to achieve organizational goals
• Assists in the development of functional strategy
• Decisions have an extended impact on work processes, outcomes, and customers
• Interacts with internal and/or external leaders, including senior management
• Persuades others into agreement in sensitive situations while maintaining positive relationships

JOB SUMMARY

Supervise nurses in a highly regulated department responsible for performing medical necessity case reviews for appropriateness of medical care and service. Supervise the day-to-day clinical operations and functions within the department, ensuring productivity and quality metrics are met.

Key Duties and Responsibilities

• Provide oversight and interpretation of state/federal regulations and NCQA standards impacting member appeals and grievances from a clinical perspective.
• Ensure that the clinical Appeals and Grievance department processes all cases in accordance with policies and procedures
• Utilize clinical expertise to serve as a resource to the team regarding escalated or complex clinical issues
• Monitor and distribute team's caseload and ensure adequate coverage
• Monitor and evaluate performance standards and provide feedback and guidance or problem resolution.
• Identify and develop opportunities for process improvement and work with various leaders to ensure problems are corrected
• Train and onboard new team members
• Audit staff to standards and provide continuous feedback
• Assist management in committee work, regulatory audits and regulatory reporting.
• Analyze and interpret state and federal regulatory requirements and NCQA standards and provide guidance to team to ensure adherence

MINIMUM QUALIFICATIONS

• Valid USRN license
• Bachelor's degree in nursing preferred.
• 3+ years of combined nursing and appeal and grievance, or utilization management or case management experience.
• Previous supervisory experience strongly preferred.
• Knowledge of coding preferred. Previous Quality Improvement experience preferred.
• Knowledge of DHCS/DMHC regulations preferred.

What Clinical Operations Management Contributes To Cardinal Health
Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.

Clinical Operations Management is responsible for strategic oversight and leadership direction within the Clinical Operations function.

Job Summary
The Director, Clinical Ops Management is responsible for the effective management of one or multiple Cardinal Health programs. This job is responsible for the financial performance of programs and also that operations are compliant with all organizational and regulatory guidelines. The Director, Clinical Ops Management works closely with manufacturers to ensure timely distribution to customers and the successful treatment of patients. This job oversees all activities related to program operation including customer support, IT and analytics.

Responsibilities

• Manages and is responsible for the performance of clinical operations programs, including meeting financial revenue and profit objectives.
• Leads large program team(s) in all functions including Operations, Quality, Production, Data Analytics, Customer Service and Nursing.
• Negotiates contracts on behalf of the organization with potential and existing customers.
• Oversees the activities of the Key Account Managers and Client Relationship Managers to ensure sales objectives and customer service levels are being met.
• Ensures the completion of quarterly business reviews with all customers related to managed programs.
• Maintains compliant operations and ensures the site is prepared for unexpected audit activity or visits from regulatory agencies.
• Collaborates with IT to improve upon product offerings by making adjustments to existing products and prioritizing technology improvement activity.
• Analyzes program data to generate routine and custom reports for internal use and for distribution to program customers.
• Performs special projects as needed to support business needs.

Qualifications

• 12+ years of experience, preferred
• 10+ years proven health care management experience, preferred
• 3+ years as a Director, preferred
• Individuals with a BSN and RN license, strongly preferred
• Previous working experience in physician offices or related US healthcare organizations with rheumatology, oncology, urology, or other therapeutic areas an advantage
• Knowledge of US health-care related computer applications including practice management systems, electronic health record systems, etc. an advantage
• Bachelor's degree in related field, or equivalent work experience, preferred

What is expected of you and others at this level

• Provides leadership to managers and experienced professional staff; may also manage front line supervisors
• Manages an organizational budget
• Develops and implements policies and procedures to achieve organizational goals
• Assists in the development of functional strategy
• Decisions have an extended impact on work processes, outcomes, and customers
• Interacts with internal and/or external leaders, including senior management
• Persuades others into agreement in sensitive situations while maintaining positive relationships

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.
Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.