97 Clinical Services jobs in the Philippines

Job Title: Clinical Services Manager

Location: McKinley, Taguig

Work set-up: Onsite

Company Overview:

AGS Health is more than a revenue cycle management company - we're a strategic partner for growth. With expert services complemented by AI-enabled technologies and high-touch support, AGS Health is the premier revenue cycle partner for leading health systems, physician groups, and academic medical centers in the U.S. With expert insight into modern revenue cycle practices, the company pairs cutting-edge technology with college-educated, trained RCM experts to help clients optimize workflow, maintain compliance, prevent revenue leakage, and achieve a high-performance revenue cycle. AGS health employs more than 14,000 team members globally and partners with more than 150 clients across a variety of care settings, specialties, and billing systems.

For more details, please visit

You can also visit us at

SCOPE OF WORK:

· The position will report directly to the Vice President of Coding and Clinical Service Line. This is an Individual Contributor role focusing on independent work and expertise within a specific area, rather than managing a team or having managerial responsibilities. The individual will be responsible for delivering improved performance/results through key stakeholder engagement and problem-solving skills.

· This role will support service line leadership collaboration with AGS teams including Operations, Sales, Customer Success, Marketing, Talent Development, and Quality Audit teams. Examples include:

o Drive quality improvement initiatives within the clinical service line

o Refine AGS's quality audit framework as industry trends and regulatory requirements evolve

o Create case studies from clinical projects utilizing "real time" key outcomes and data

o Participate in general go-to-market initiatives as needed

· The individual will monitor clinical pipeline to build thoughtful presentations for leadership meetings, strategic initiatives and other efforts. Navigate sales platform, quantify relevant pipeline, and assist with prioritizing pursuits.

· The individual will work adjacent to the Sales / Customer Success teams to build compelling value propositions and customized solutions during the sales cycle. May require researching competition and updates on global market trends within the clinical RCM domain.

· This position will also support the Director – Clinical Education with development and refinement of education and training content for AGS resources within the clinical service lines (Clinical Authorizations, Clinical Denials & Appeals, Physician Advisory Services, Clinical Documentation Integrity, and Utilization Review) across global locations

· This role will also support the expansion into new clinical administrative service lines such as care management and coordination, pharmacovigilance, etc.

JOBS-TO-BE-DONE (JTBDs):

1. Serve as clinical SME in support of the following:

a. Support VP of Coding and Clinical Service Line – Drive operational excellence and collaboratively assist the VP with tasks to execute the organization's strategy for the relevant service lines.

b. Go to Market Support – Be able to communicate effectively to internally and externally with clinical domain acumen. Support AGS's thought leadership by researching and creating content for market-focused communications (e.g., white papers, collaterals, case studies, clinical sections of the website, webinars). Help ensure the content remains current with industry-leading solutions and delivery locations.

c. Clinical analytics – assist with the identification and collection of key performance indicators for the clinical service lines; utilize current project data to generate insights related to production, quality, and outcomes for both external and internal uses.

d. Education and Training – Support the Director Clinical Education to develop and refresh clinical services training content. Assist with the collaboration among AGS internal teams, including Talent Development and Operations, for a comprehensive approach. Knowledge of industry trends and regulatory compliance matters will be important.

1. Support the refinement, further development, and implementation of the company's Clinical Solutions strategy in line with AGS's long-term (5+ year) strategic plan

2. Support other clinical service line initiatives as requested.

KEY SELECTION CRITERIA:

Candidate qualifications:

1. Minimum of 5+ years combined experience in direct patient care and/or a clinical administrator role such as: utilization management, clinical authorization, clinical denials or clinical documentation integrity with a professional history in reputable companies.

a. Registered Nurse (RN) or other clinical patient care designation

b. BS/BA is required and a graduate degree in health, medicine, or nursing is preferred

c. Adjacent experience with US revenue cycle is a plus

1. Knowledge of the US healthcare industry, including a broad understanding of both the payor and provider ecosystems and how they interrelate. Grasp of clinical RCM vendors / services / trends / disruptions / service differentiators.

2. Strong understanding and experience working with revenue cycle-related technology in the clinical revenue cycle, including computer-assisted CDI, auditing, utilization management review, clinical appeal automation, etc.

3. Global Experience – preferred experience of 2+ years of working in/with global RCM business process outsourcing delivery models

4. Ability to constantly learn and synthesize – active listener with intellectual curiosity. Keep up to date on industry trends to shape the Solutions framework and intellectual property for the service line.

5. Product knowledge – broad understanding of AGS products/services and how they interplay, coupled with strong knowledge of technology solutions and platforms

6. Demonstrates initiative and strives for excellence for him/herself and his/her team.

Compliance:

Awareness and adherence to all applicable organization-wide policies and procedures, including but not limited to Information security, HIPAA, and HR policies

· Should adhere to applicable Do's & Don'ts of implemented Information Security Management System, including HIPAA, HITRUST, and NIST regulations

· Adherence to the rules and regulations as outlined by the management

KEY SUCCESS FACTORS:

· Fluent in English. Professional and polished written and verbal communication skills

· Analytical thinking

· Desire to operate in a fast-paced environment and work with a cross-functional team spread across different geographical locations

· BPO industry knowledge, including an understanding of enabling functions (quality, training, hiring, technology, pricing, etc.) and operating environment

· Ability to work seamlessly with virtual teams

Clinical Services Team Leader (Philippines)

About Interstaff

Interstaff is an international healthcare staffing company that recruits nurses from all over the world and

places them in hospitals throughout the United States. Founded in 1998, Interstaff has a strong track

record and was a pioneer of the international staffing model. As we look ahead to celebrating our 22nd

year in business we also look forward to adapting to the growing needs of the U.S. healthcare system.

Our team culture is one of passion and mutual support. You can expect to feel truly supported and

empowered to do your job well. At Interstaff, we take pride in serving our nurses and client hospitals.

Job Description Summary:

The Clinical Services Team Leader role is a full-time, Philippines based position, whose job is to facilitate

document collection and processing for registered nurse credentialing (licensing, compliance &

onboarding), and facilitate nurse support activities. The team leader communicates daily with nurses

regarding their outstanding credentialing documents and facilitates the team's continuous improvement of

the same. Great communication skills and an overwhelming sense of responsibility is critical for success

in this position.This is a fully-remote, work-from-home role.

Job Responsibilities

• Work within ISI systems (Zoho, Canvas, Basecamp, Google)

• Attain expertise in external client hospital document collection and onboarding systems

• Oversee the maintenance of working nurse compliance records in client systems

• Facilitate document review, submission, and processing of nurse documents for onboarding and

ongoing compliance

• Escalate deficiencies to Credentialing Manager for follow-up

• Document all communication with working nurses, clients, and ISI team in ISI systems

• Collaborate with the onboarding and compliance team to suggest improvements to internal

processes

• Assist the Clinical Services team in other areas when time allows as requested by leadership.

Team leadership:

• Participate in the hiring process for new Clinical Services team members.

• Provide training to new team members joining the Clinical Services team.

• Provide feedback to the team members for continuous improvement in the credentialing

processes.

• Provide feedback to the Credentialing Manager regarding team member performance during

semi-annual performance reviews, and as necessary.

• Assist with process improvement for credentialing.

Education, Training, and Experience

• Minimum of 2 years experience in a related field

• Minimum of Associate's Degree in related field

• Strong English proficiency

• Data entry and/or database experience

• High level of accountability, proven ability to take ownership and solve problems

• Demonstrated ability to work in a team-oriented, collaborative environment

• Time management skills and self-efficiency

• Analytical thinker with strong conceptual and problem-solving skills

• Meticulous attention to detail with the ability to multitask

• Ability to work under pressure and meet deadlines

• Excellent documentation, communication, and computer skills

• High level of integrity and trustworthiness.

Job Type: Full-time

Pay: Php29, Php35,000.00 per month

Benefits:

• Company events
• Health insurance
• Opportunities for promotion
• Paid training
• Work from home

Application Question(s):

• Do you have advanced proficiency in using CRM platforms? What CRM tools have you used? (answer is required)
• What internal systems or databases have you used before for data entry or tracking documents? (answer is required)
• Do you have advanced proficiency in using Google Suite- form, work, excel? (answer is required)

Experience:

• Credentialing or related: 2 years (Required)

Work Location: Remote

Expected Start Date: 10/01/2025

---ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE---

POSITION TITLE: Health Clinical Services Manager

WORK SETUP: Return to Office

RESPONSIBILITIES:

• Lead and manage the clinical training strategy for global BPO teams supporting utilization management, case management, and health management processes.
• Develop, implement, and evaluate training programs that ensure compliance with healthcare industry standards, regulations, and best practices.
• Create and deliver engaging training materials (e.g., e-learning modules, instructor-led training, job aids) tailored to the needs of global BPO teams.
• Assess the skill levels and performance of clinical staff, identifying areas for improvement and implementing targeted training solutions.
• Monitor and ensure the quality of training delivery across multiple regions, ensuring consistency in content and effectiveness.
• Collaborate with cross-functional teams (e.g., operations, quality assurance, clinical management) to align training efforts with organizational goals and compliance requirements.
• Provide ongoing coaching and mentoring to clinical trainers and BPO staff, fostering a culture of continuous learning and development.
• Evaluate training effectiveness through assessments, feedback surveys, and performance metrics, making data-driven improvements to training programs.
• Develop and manage a comprehensive knowledge base for clinical processes, procedures, and best practices to be accessed by BPO teams.
• Ensure that clinical training programs align with client needs, adapting content as necessary to meet specific client requirements and regulations.
• Support the integration of new technologies and tools into training programs, ensuring clinical staff are proficient in using the latest healthcare management systems.
• Stay current on industry trends, regulations, and best practices in utilization management, case management, and health management to continuously improve training content.
• Track and report on training progress, providing regular updates to senior management regarding program outcomes and team performance.
• Manage relationships with external vendors and training partners, ensuring that third-party training content aligns with organizational and regulatory requirements.

OTHERS:

Project Shift Schedule: Night shift

Project Rest Day: Weekends Off

Project/Team Location: Taguig Uptown Bonifacio Tower 3

SKILLS AND QUALIFICATIONS:

• 8 to 12 years of solid experience as Health trainer,
• Individual contributor role
• Experience in BPO Health accounts
• Must be open to BPO & Non-BPO Experience

Good to have only:

• Registered Nurse License
• Physician License

• ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE--- POSITION TITLE: Health Clinical Services Senior Manager WORK SETUP: RTO Responsibilities:
• Oversees staff whose teams' primary duties may include, but are not limited to:
• Conducts pre-service, concurrent, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
• Service requests may be from inbound calls and facsimile.
• Outbound calls to the provider may be required to gather additional information that may be needed.
• Other staff responsibilities may be review and analysis of post service claims utilizing the member's benefit contract and health plan guidelines.

• Completes review of pended claims post service for either Medical Necessity or Contractual Reviews. OTHERS: Project Shift Schedule: Night Shift Project Rest Day: Weekends Project/Team Location: Taguig Uptown Bonifacio Tower 3
  SKILL AND QUALIFICATIONS:

• At least 12 years relevant experience and 10 years supervisory

• Holds current and unrestricted US Registered Nurse license. No state specific RN licensure required.
• BPO experience should be any account (Health account experience is only a plus, but not required)
• Work Background/Experience in General: Must be open to BPO & Non-BPO Experience

Before you apply

This job is only open to employees of the HSE, TUSLA, Section 38 agencies, or statutory health agencies per WRC Agreement

Reference

25UHWM1210

Category

Management/Admin/ICT

Grade

Grade VII 0582

Advertisement source

HSE

Advertisement Type

Internal

Important Information

This job is in the HSE.

Health region

HSE South West

County

• Waterford

Location

University Hospital Waterford

Recruiter

HSE Dublin and South East: Tipperary South, Waterford, Kilkenny, Carlow, Wexford, Wicklow, part of South Dublin

Contract type

• Permanent Wholetime

Post specific related information

Please ensure you download, save and read the Job Specification, Additional Campaign

Information as well the Application Form. All of these documents are located at the bottom of this advertisement. We strongly recommend that you read the Job Specification before completing your application form.

Closing date

24/10/ :00:00

Proposed interview date

To be confirmed

Informal enquiries

Ms. Deirdre Latimer, Non Clinical Support Services Manger

University Hospital Waterford & Kilcreene Regional Orthopaedic Hospital

Tel:

External link

Job Description:

Primary Responsibility:

The Clinical Applications Services Quality Assurance (CASQA) Analyst is responsible for ensuring that all system enhancements, process changes, and related documentation meet the highest standards of quality, functionality, and compliance before deployment. This role focuses on validating that the developed solution aligns with clinical requirements, is free of defects, and adheres to established protocols and best practices.

Key Functions:

1. Test Planning and Design:

a. Collaborate with the Clinical Applications Services Functional Business Analyst (CASFBA) to review enhancement specifications and define testing scope and objectives.

b. Develop comprehensive test plans, test cases, and test scripts based on the finalized requirements to ensure full coverage of the system's functionality.

c. Prepare and stage appropriate test data required for various testing scenarios.

2. Testing and Validation:

a. Execute System Integration Testing (SIT) in collaboration with the CASFBA and Clinical Applications Services Configuration Business Analyst (CASCBA) to identify, document, and report bugs and issues.

b. Conduct regression testing to ensure that new enhancements do not negatively impact existing system functionalities.

c. Support the Medical Informatics Department (MID) and end-users during User Acceptance Testing (UAT), providing clarification on test cases and expected outcomes.

d. Certifies that a system enhancement has passed all required SIT scenarios before it is endorsed for UAT.

e. Determines if a discovered issue is a "process-blocking scenario" that must be resolved before deployment can proceed.

Job Type: Full-time

Pay: Php60, Php65,000.00 per month

Benefits:

• Opportunities for promotion
• Promotion to permanent employee

Work Location: In person

Job Title: Clinical Applications Services Quality Assurance (CASQA)

Job Description:

Primary Responsibility:

The Clinical Applications Services Quality Assurance (CASQA) Analyst is responsible for ensuring that all system enhancements, process changes, and related documentation meet the highest standards of quality, functionality, and compliance before deployment. This role focuses on validating that the developed solution aligns with clinical requirements, is free of defects, and adheres to established protocols and best practices.

Key Functions:

1. Test Planning and Design:

a. Collaborate with the Clinical Applications Services Functional Business Analyst (CASFBA) to review enhancement specifications and define testing scope and objectives.

b. Develop comprehensive test plans, test cases, and test scripts based on the finalized requirements to ensure full coverage of the system's functionality.

c. Prepare and stage appropriate test data required for various testing scenarios.

1. Testing and Validation:

a. Execute System Integration Testing (SIT) in collaboration with the CASFBA and Clinical Applications Services Configuration Business Analyst (CASCBA) to identify, document, and report bugs and issues.

b. Conduct regression testing to ensure that new enhancements do not negatively impact existing system functionalities.

c. Support the Medical Informatics Department (MID) and end-users during User Acceptance Testing (UAT), providing clarification on test cases and expected outcomes.

d. Certifies that a system enhancement has passed all required SIT scenarios before it is endorsed for UAT.

e. Determines if a discovered issue is a "process-blocking scenario" that must be resolved before deployment can proceed.

Job Type: Full-time

Pay: Php60, Php65,000.00 per month

Benefits:

• Opportunities for promotion
• Promotion to permanent employee

Work Location: In person

The Clinical Applications Services Quality Assurance (CASQA) Analyst is responsible for ensuring that all system enhancements, process changes, and related documentation meet the highest standards of quality, functionality, and compliance before deployment. This role focuses on validating that the developed solution aligns with clinical requirements, is free of defects, and adheres to established protocols and best practices.

Key Functions:

1. Test Planning and Design:

2. Collaborate with the Clinical Applications Services Functional Business Analyst (CASFBA) to review enhancement specifications and define testing scope and objectives.

3. Develop comprehensive test plans, test cases, and test scripts based on the finalized requirements to ensure full coverage of the system's functionality.

4. Prepare and stage appropriate test data required for various testing scenarios.

5. Testing and Validation:

6. Execute System Integration Testing (SIT) in collaboration with the CASFBA and Clinical Applications Services Configuration Business Analyst (CASCBA) to identify, document, and report bugs and issues.

7. Conduct regression testing to ensure that new enhancements do not negatively impact existing system functionalities.
8. Support the Medical Informatics Department (MID) and end-users during User Acceptance Testing (UAT), providing clarification on test cases and expected outcomes.
9. Certifies that a system enhancement has passed all required SIT scenarios before it is endorsed for UAT.
10. Determines if a discovered issue is a process-blocking scenario that must be resolved before deployment can proceed.

• Health Insurance
• Standard Statutory Benefits (SSS, Pagibig, Philhealth, 13th Month)
• Allowance

The Clinical Applications Services Quality Assurance (CASQA) Analyst is responsible for ensuring that all system enhancements, process changes, and related documentation meet the highest standards of quality, functionality, and compliance before deployment. This role focuses on validating that the developed solution aligns with clinical requirements, is free of defects, and adheres to established protocols and best practices.

Key Functions:

1. Test Planning and Design:

2. Collaborate with the Clinical Applications Services Functional Business Analyst (CASFBA) to review enhancement specifications and define testing scope and objectives.

3. Develop comprehensive test plans, test cases, and test scripts based on the finalized requirements to ensure full coverage of the system's functionality.

4. Prepare and stage appropriate test data required for various testing scenarios.

5. Testing and Validation:

6. Execute System Integration Testing (SIT) in collaboration with the CASFBA and Clinical Applications Services Configuration Business Analyst (CASCBA) to identify, document, and report bugs and issues.

7. Conduct regression testing to ensure that new enhancements do not negatively impact existing system functionalities.
8. Support the Medical Informatics Department (MID) and end-users during User Acceptance Testing (UAT), providing clarification on test cases and expected outcomes.
9. Certifies that a system enhancement has passed all required SIT scenarios before it is endorsed for UAT.
10. Determines if a discovered issue is a process-blocking scenario that must be resolved before deployment can proceed.

• Health Insurance
• Standard Statutory Benefits (SSS, Pagibig, Philhealth, 13th Month)
• Allowance