11 Healthcare Management jobs in the Philippines

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

Position: Project Management & Implementation Specialist

Employment Set Up: 100% WFH / Remote

Initial Contract: 6 months with Potential to Convert to Full Time role

Start Date: ASAP

Shift Schedule: GY Shift (EST Time Zone)

About the Role & the Team

The Business Operations & Analytics team helps the company monitor performance, understand key business drivers, and make data-driven decisions to optimize operations and accelerate growth. In addition, the Project Management & Implementation specialist, works directly with individual departments to coordinate efforts improving existing workflows, expanding the leverage of technology and evolving our products. The Project Management & Implementation Specialist will lead organizing, evaluating, planning, and implementing, improvements to existing operational process designs and Net new initiatives across multiple departments.

Key Responsibilities

• Lead & support process planning and improvement initiatives across multiple business divisions in support of strategic and operational efficiency efforts
• Process Improvement & Project Implementation support includes root cause and gap analysis, design/scoping, business modeling, cross-functional alignment, documentation, implementation project management, and performance monitoring to ensure that people/process/technical solutions align with strategic initiatives
• Ensure the timely delivery of project results that meet or exceed agreed-upon metrics or goals
• Experience in change management, stakeholder management, and influencing people without authority
• Facilitate and support business case development process to identify and quantify the impact of changes on various functions and processes throughout the company to achieve business objectives
• Create and maintain strong working relationships across the Company to foster awareness of operational efficiency efforts and the impact of process design and improvement projects
• Assist with and assess processes against compliance and quality standards

Minimum Qualifications:

• 3-5 years of experience in healthcare project management, new initiative implementation and/or integrations of acquisitions; including process documentation, project planning & management, cross-functional alignment, and metrics tracking
• Knowledge and understanding of Business Process Engineering standards/protocols
• Strong Leadership skills
• Mastery of Google Suite, Microsoft Office, etc. (especially PowerPoint/Slides and Excel/Sheets)
• Strong interpersonal and written/ oral communication skills, with the ability to communicate effectively across functions and levels of management
• Strong attention to detail and organization skills
• Action-oriented and entrepreneurial mindset

Must-Haves (Non-Negotiables)

• Minimum 3 years of healthcare experience
• Must work Eastern Time hours
• Clear English communication with minimal accent issues (client-facing role)
• Strong soft skills: proactive, independent, and able to take ownership of tasks (e.g., scheduling meetings, leading agendas, preparing presentations)
• Immediate availability for onboarding

Nice-to-Haves

• Medicaid experience (highly valued but not required)
• Strong presentation skills and ability to prepare materials daily

Preferred Qualifications:

• Healthcare experience (Healthcare services, Health system or Large ambulatory groups)
• Lean Six Sigma certification (e.g., yellow belt, green belt, black belt, master black belt, or other)
• Operating or analytics experience at a high-growth company
• Proficient in BI reporting tools (Tableau, Looker, or PowerBI)
• Domain knowledge or expertise in Medicaid is a huge plus

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

Hiring: Virtual Assistant US Healthcare Accounts Receivable / Claims Management Specialist
Remote | Full-time / Part-time

Vital Virtuals Global HR Solutions is looking for a
Virtual Assistant
with at least
1 year of experience in Medical Billing and US Healthcare Accounts Receivable & Claims Management
.

Responsibilities:

• Follow up on outstanding claims
• Handle denials, appeals, and resubmissions
• Manage collections & patient balances
• Maintain AR reports & update claim statuses

Qualifications:

• 1+ year AR/claims experience
• Knowledge of billing, denials & collections
• Familiar with EMR/EHR systems (preferred)
• Organized, detail-oriented, strong communicator

Compensation & Benefits:

• $5/hr (first 90 days), $6/hr after
• HMO after 6 months
• Remote, flexible, career growth opportunities

Tools: Time Doctor, Virtual Desktop (Zoom for communication)

Job Qualifications:

• Completed at least 2 years of college.
• Minimum 12 months experience in Healthcare Account Receivable/Collections in a BPO setting.
• Familiarity with UB Claims and UB04 forms.
• Experience in medical billing/AR collections.
• Background in calling insurance (Payer) for claim status and payment disputes.
• Familiar with EPIC SYSTEM.
• Willing to work on-site in Taguig.
• Experience in a BPO Healthcare Account is required.

Primary Responsibilities:

• Read contracts for payment disputes.
• Work on the provider side.
• Verify claim status and collect unpaid claims from insurance.
• Process claims payments, manage denials, and track claim statuses.
• Manage collections for healthcare unpaid claims.
• Interact with customers to ensure invoice accuracy and resolve claims discrepancies.
• Provide input on policies, systems, methods, and procedures for premium collection management.
• Educate customers on online applications for claims and payments.
• Monitor outstanding balances and ensure clients pay as billed.
• Prepare invoices and reconcile billing with accounts receivables.
• Conduct quality assurance and audits of collection activities.
• Handle documents, emails, and calls related to account processes.
• Perform accounts receivable collections, follow-up, denial management, claims payment processing, tracking, and appeals for hospital processes.

Your role is critical in providing confidence in the exceptional care we offer to our members, families, facilities, and health professionals. This is an everyday opportunity to do your life's best work.

WHAT WE OFFER

• Market Competitive Pay Levels
• Fast Processing No Exam Hiring
• Retirement Plan
• Medical Plan (HMO) from Day 1 of employment
• Dental, Medical, and Optical Reimbursements
• Life and Disability Insurance
• Paid Time-Off Benefits
• Sick Leave Conversion
• Tuition Fee Reimbursement
• Employee Assistance Program (EAP)
• Annual Performance Based Merit Increases
• Employee Recognition
• Training and Staff Development
• Employee Referral Program
• Employee Volunteerism Opportunity
• All Mandatory Statutory Benefits

WHO WE ARE

• Optumis the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.
• UnitedHealth Groupis 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

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.