Internal Care Manager - USRN

Manulife

Lapu-Lapu City, Cebu
Permanent
Full-time

26 days ago

We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and meaningfully challenged, we all thrive. Discover how you can grow your career, make impact and drive real change with our Winning Team today.Working Arrangement HybridJob DescriptionAre you looking for a supportive and collaborative workplace with great benefits and clear career development? You’ve come to the right place.Why choose Manulife?

Competitive Salary packages and performance bonuses
Day 1 HMO + FREE coverage for your dependents (inclusive of same-sex partners)
Retirement savings benefit
Rewarding culture that values wellness and well-being
Performance Bonus
Global network of industry experts
Extensive training resources

Job DescriptionThe Internal Care Manager - USRN role is responsible for using clinical expertise to assess clinical information on low to moderate exposure claims consistent with current business protocols. Accountable for ensuring the accuracy of the clinical evidence to compare against policy or plan language in order to determine benefit eligibility on LTC claims. This role exists to ensure that only those policyholders meeting their policy’s criteria for eligibility remain approved.Have the skills and knowledge for the job? Learn more about the opening below!Key Responsibilities:

Assess clinical needs to determine ongoing eligibility for long term care benefits
Ongoing monitoring of claims for high-risk activity
Make benefit eligibility determinations based on onsite/virtual assessments, functional/cognitive screening forms and/or other clinical evidence on ongoing claims
Appropriately set clinical follow updates based on current protocols
Complete trainings as assigned to maintain currency with protocol and guideline updates
Collaborate with other business units as needed to provide optimum service to customers
Participate in regular one-on-one meetings with management, attend staff meetings and attend other work activities as directed by manager
Collaborate with senior care management staff on specific claim questions to ensure accurate decision-making

Qualifications:License: US Registered Nurses (NY license preferred but not required)Education: Bachelor's Degree in Nursing preferably specializing in geriatric or long term care and/or chronic illness fieldsExperience: Clinical nursing or claims processing experience is an advantageLocation: Mactan Newtown in CebuWork Arrangement: HYBRID Work Arrangement – amenability and readiness to work onsite during training and from home anytime (dependent on business needs OR current external environment/situation).Language: Excellent English skillsSkills and Competencies:

1.Adaptability – quick study; agile and flexible to any situation 2. Analytical and Decision-Making skills – analyze cases and claims, identify if valid and provide recommendations
3. High level of Attention to details
4. Ability to contact providers for clarification needed in order to determine benefit eligibility
5. Fluency with MS Office and ability to learn new computer applications easily.

Let's make every day better together. Learn about our opportunities at JOBS.MANULIFE.COMAbout Manulife and John HancockManulife Financial Corporation is a leading international financial services group that helps people make their decisions easier and lives better. With our global headquarters in Toronto, Canada, we operate as Manulife across our offices in Asia, Canada, and Europe, and primarily as John Hancock in the United States. We provide financial advice, insurance, and wealth and asset management solutions for individuals, groups and institutions. At the end of 2022, we had more than 40,000 employees, over 116,000 agents, and thousands of distribution partners, serving over 34 million customers. At the end of 2022, we had $1.3 trillion (US$1.0 trillion) in assets under management and administration, including total invested assets of $0.4 trillion (US $0.3 trillion), and segregated funds net assets of $0.3 trillion (US$0.3 trillion). We trade as ‘MFC’ on the Toronto, New York, and the Philippine stock exchanges, and under ‘945’ in Hong Kong.Manulife is an Equal Opportunity EmployerAt Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact .

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