57 Healthcare jobs in Pililla

Qualifications:

 A graduate of Radiologic Technology.

Licensed Radiologic Technologist

ust have training, certification, and at least one (1) year experience relevant to the job.

ood communication skills.

omputer literate with proficiency in MS Office, using MS Word, and MS Excel.

riving (advantage but not a basic qualification).

Job Description:

erforms different X-ray procedures and can assist radiologist.

an analyze findings of the X-ray results.

roper recording and filing of the CD’s of film.

 er duties deemed necessary by the Immediate Head.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Primary Responsibilities:**
+ Initial behavioral health triage of members in a call center environment
+ Analyze and investigate members' questions
+ Provide explanations and interpretations of benefits/coverage, benefit authorizations, treatment plan processing and assistance in finding behavioral health services
+ 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
What makes your clinical career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You can work with in an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
**Required Qualifications:**
+ Masters degree in a Behavioral Health field (Counseling, psychology, social work, human services)
+ 1+ years of experience in Behavioral Health field with direct client contact
+ Basic level of computer skills in a professional setting, ability to toggle between systems and type 35 - 40 WPM
**Preferred Qualification:**
+ 1+ years of experience in a call center
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Primary Responsibilities:**
+ Successful implementation and management of the training department
+ Training fresher, existing and experienced colleagues for all scopes of work in backend business of RCM
+ Delivering training programs to employees using a variety of methods, including classroom instruction, e-learning and on-the-job training
+ Review training needs and performance monthly basis and perform focus group, conduct feedback and monitor progress of the batches till they become productive as 100%
+ Bottom quartile management
+ Plan and implement an effective training curriculum, content and automation
+ Collaborate with management to identify training needs (TNI or TNA) for all employees
+ Regularly connect with ops, quality and training to enhance the training and identify the area of improvement
+ Maintaining up-to-date knowledge of best practices in training and development and making recommendations for changes to training programs as required
+ Be able to raise or track new hire process credentials
+ Be able to work on the accounts for the aligned process to have hands-on experience for better for experiential training
+ Learn new or existing business as end to end and prepare or modifier the training curriculum
+ Be able to align themselves with organization or team or client culture and mission, vision and value
+ Be well equipped in handling in-person and virtual training
+ 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:**
+ 5+ years of experience in the US healthcare industry with acute and ambulatory billing
+ 5+ years of experience in healthcare revenue cycle management services, with understanding of upstream and downstream
+ Worked as AR representative and effectively implemented the experiential learning in the new hire batches
+ In-depth knowledge of denial management and appeal writing for both administrative and clinical denials
+ In-depth knowledge of Acute and Ambulatory specialties with understanding of associated diagnosis, procedure and denials
+ Comprehensive knowledge of UB04 claim form component, including proper inpatient coding, revenue codes, procedure codes, and regulatory requirement
+ Familiarity with insurance guidelines (Medicare, Medicaid, commercial payers) and their plans
+ Expertise in handling inpatient claims and understanding payment methodologies- DRG classifications, bundled payment models)
+ Proficiency in understanding coding denials and code sets (ICD-10, CPT04, HCPCS) and understanding of medical records
+ Demonstrated ability to analyze AR claim as end to end and identify the root cause and faster resolution
+ Demonstrated ability to handle multiple geos - US/PR/PHL/IND
+ Proven solid analytical and problem-solving skills
+ Proven excellent communication and leadership abilities
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Primary Responsibilities:**
+ Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities
+ Analyze, identify trends and provide reports as necessary
+ Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
+ Manage subrogation files
+ 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
This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast paced environment that takes focus, intensity and resilience.
**Required Qualifications:**
+ High school diploma or GED or equivalent work experience
+ 1+ years of claims or collections experience
+ 1+ years of experience analyzing and solving customer problems
**Preferred Qualifications:**
+ Experience working with subrogation
+ Experience with negotiations
+ Experience working in the health care industry
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
All of us have a short list of the things that make a job great. If your list includes being able to make a difference, count us in as your next place to work. UnitedHealth Group is a Fortune 5 leader in health care at a time when health care is evolving for everyone. Our billing teams are part of an important chain of events that impact the lives of our members in positive ways. Join this group and we'll have an impact on you. Apply now and discover the exceptional training, support and opportunities to grow that you'd expect from a Fortune 5 leader.
**Primary Responsibilities:**
+ Interact with customers to gather support data to ensure invoice accuracy and also work through specific billing discrepancies
+ Provide input to policies, systems, methods and procedures for the effective management and control of the premium billing function
+ Educate customers regarding the availability of receiving invoices and remitting payments through online applications
+ Monitor outstanding balances and take appropriate actions to ensure clients pay as billed
+ Manage the preparation of invoices and complete reconciliation of billing with accounts receivables
+ 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
What makes this a special challenge? For one, we want to create a quality experience for every person we serve. So the bar is high for accuracy, communications style and effectiveness. Also, you'll need to be researching and resolving problems before, during and after calls within a high volume, demanding environment.
**Required Qualifications:**
+ An education level of at least a high school diploma or GED OR equivalent years of working experience
+ Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
+ Ability to multi-task and to understand multiple products and multiple levels of benefits within each product
+ Able to work a 40 hour schedule within the operating hours of the site
**Preferred Qualifications:**
+ 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
+ Experience in billing or collections
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved._

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Primary Responsibilities:**
+ Provide expertise claims support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities
+ Analyze and identify trends and provides reports as necessary
+ Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
+ 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:**
+ An education level of at least a high school diploma or GED OR 10 years of equivalent working experience
+ 4+ years of experience in claims recovery and resolution
+ Moderate proficiency with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
+ Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
**Physical Requirements and Work Environment:**
+ Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved._

Job Overview (South West Luzon territory)
+ Provide customers with training, clinical in-services, and information regarding specific disease states and product.
+ Accelerate disease state awareness.
+ Provide education programs for professional staff, i.e. doctors, nurses, other key healthcare staff through 1:1 presentation, round table discussions, and formal presentations
+ Accept all assignments within 24 hrs. of receiving notification.
+ Notify manager if unable to accept a patient assignment or schedule a patient visit within 72 hours due to other special circumstances.
+ Report any Adverse Event per guidelines.
+ Evaluate the medical safety of adverse events, trends, and proposes mitigating activities.
+ Responsibility for achieving qualitative and quantitative targets and objectives of the project.
+ Active involvement during the development of project as well as responsibility for implementation in line with project scope and defined project plan in coordination with the customer.
+ Advising the customer within an ongoing project to identify bottlenecks and opportunities and derive resulting adaptation within project operation with the aim of optimizing productivity, delivery and quality.
+ Day to day project management including prioritization, allocation of tasks and resources, application of new skills and knowledge, communication management, time and schedule management, tracking of financial performance and risk management.
+ Close collaboration with Key Account Manager and Business Development
+ Responsibility as a Senior in the project for the target-oriented leadership of the internal project team (Project Support Associate etc.) and the Field Nurses.
+ Coordinating decisions regarding recruitment and retention, personnel development, salaries and disciplinary actions in assigned projects.
+ Active involvement in objective setting for Line Managers (IQVIA managed projects) and field staff.
**Essential Functions**
+ Completes all reports and written assignments in a timely, accurate, and thorough manner per set timelines and customer expectations.
+ Maintains a high level of professional standards in all interactions with patients and customer contacts.
+ Reads, understands, and adheres to important documents such as fraud and abuse guidelines, FDA Philippines guidelines, Pharma code and HIPPA guidelines and memos regarding policy and procedures.
**Qualifications**
+ Pharmaceutical industry experience preferred.
+ Clinically competent in disease area.
+ Understanding and general knowledge of health service.
+ Good working knowledge of national clinical systems.
+ Ability to manage own workload with minimal guidance.
+ Ability to establish and maintain effective working relationships with co-workers, managers and clients.
+ Current nursing license/nutritionist dietician license in good standing.
+ Driver Licence - Valid.
#LI-CES
#LI-PK1
#LI-DNP
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled

**Roles and Responsibilities:**
+ Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
+ Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards
+ Communicates with members, providers, facilities, and other departments regarding appeals requests
+ Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards
+ Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests
+ Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices
+ Individuals have a well-rounded knowledge of the policies and procedures for appeals processing, specifically Medicare and medical necessity review.
+ Uses sound judgment, especially in non-routine appeals, to make decisions to keep the appeal process moving forward in accordance with contractual timeliness standards
+ Maintain files on individual appeals by gathering, analyzing and reporting verbal and written member and provider appeals.
+ Review claim appeal for reconsideration and recommend approvals/denials based on determination level or prepare for medical review presentation.
+ Prepare case recommendations for medical review as necessary.
**Requirements:**
+ 2 - 4 years of experience in processing appeals or utilization management
+ RN - Registered Nurse - State required Licensure and/or Compact State Licensure
+ Knowledge of utilization management processes
+ Knowledge of NCQA, Medicare and Medicaid regulations
+ Good communication (Demonstrate strong reading comprehension and writing skills)
+ Able to work independently, strong analytic skills
Required shift timings:
US daytime

**A DAY IN A LIFE:**
Responsible for communicating ethically and delivering science based value propositions building the image and the role of Nestlé Infant Nutrition with HealthCare Professionals and institutions, within a specified territory, in order to compliantly drive recommendation/advocacy /prescriptions for these products.
**KEY RESPONSIBILITIES:**
+ Develop and expand brand usage through engagements with Health Care Professionals and Health Care Institutions.
+ Implement ethical marketing plans to further develop brand.
+ Communicate scientific and factual information to health care professionals to update them on latest product breakthroughs.
+ Coordinate with trade counterparts for product availability, market hygiene, and completeness of product range.
+ Manage all aspects of assigned responsibilities and administrative functions inherent in the operation of the assigned territory.
**WHAT WILL MAKE YOU SUCCESSFUL:**
+ Must be driving a car with a valid driver's license for at least 1 year.
+ Preferably with a science-related degree in Physiology/Nutrition/Medicine/Biology/Pharmacology/Nursing/Food Science or other Human -or Nutrition science-related field.
+ Marketing or business-related qualification can be considered.
+ Previous medical delegate or pharmaceutical representative experience working in a multidisciplinary team with different healthcare practitioners and/or in a healthcare sales environment coordinating and presenting to groups of people are an advantage.
_Nestlé Philippines is an equal opportunity employer. We provide equal employment opportunities to applicants regardless of age, color, race, origin, nationality, religion, civil status, disabilities, medical condition, pregnancy, whether with or without children, genetic information including family medical history or any other legally protected conditions, and gender identity or expression including any individual who is transitioning, has transitioned, or is perceived to be transitioning, All employment decisions are based on qualifications, merit, business needs, and in compliance with labor laws. We are committed to providing reasonable accommodations to qualified individuals with disabilities._
We are Nestlé, the largest food and beverage company. We are 308,000 employees strong driven by the purpose of enhancing the quality of life and contributing to a healthier future. Our values are rooted in respect: respect for ourselves, respect for others, respect for diversity and respect for our future. With more than CHF 91.4 billion sales in 2018, we have an expansive presence with 413 factories in more than 85 countries. We believe our people are our most important asset, so we'll offer you a dynamic inclusive international working environment with many opportunities across different businesses, functions and geographies, working with diverse teams and cultures. Want to learn more? Visit us at .