Archives Jobs

Project Manager

Position Summary:

We are seeking a skilled and experienced Project Manager to lead and deliver IT infrastructure and cloud migration projects within an enterprise environment. The ideal candidate will demonstrate strong technical expertise, exceptional stakeholder management, and a proven track record of delivering projects within scope, budget, and timelines. This role requires collaboration with distributed teams, application of Agile and Waterfall methodologies, and a focus on achieving business objectives through effective project management practices.

Job Details:

  • Work from Home
  • Monday to Friday | 4 PM to 1 AM Manila Time

Responsibilities

  • Project Delivery: Manage end-to-end project delivery, from design and discovery to go-live, ensuring successful outcomes within agreed timescales and budgets.
  • Stakeholder Engagement: Communicate effectively with key stakeholders, providing regular updates, presentations, and reports on project status, issues, risks, and progress.
  • Team Management: Lead and motivate project teams and stakeholders, applying Scrum Master methodologies to foster collaboration and achieve project goals.
  • Budget Management: Oversee project budgets, ensuring financial controls are in place and projects are delivered within financial constraints.
  • Planning and Prioritization: Contribute to regular planning processes for project and resource prioritization, aligning deliverables with business objectives.
  • Governance and Reporting: Ensure regular project reporting, governance, and tracking mechanisms are in place to monitor progress and address risks proactively.
  • Collaboration: Work with distributed teams to achieve project goals, maintaining flexibility to travel as required.
  • Technology Insight: Leverage knowledge of modern infrastructure technologies, including cloud platforms, on-premise hosting, networking, and SaaS platforms, to guide project delivery.

Qualifications

  • Education and Experience:
    • IT-related degree preferred or equivalent extensive IT experience.
    • Experience working within enterprise-sized organizations and technologies.
    • Demonstrated expertise in datacentre migrations, cloud migrations, and modern infrastructure delivery projects.
  • Certifications:
    • Project Management certifications in Scrum and Prince2.
    • ITIL certification (desirable).
  • Technical Skills:
    • Experience with cloud computing technologies, preferably Microsoft Azure.
    • Familiarity with Jira or similar enterprise project management tools.
    • Proficiency in Agile and Waterfall methodologies.
  • Key Competencies:
    • Excellent communication, presentation, and stakeholder engagement skills.
    • Proven ability to manage multiple projects within distributed teams.
    • Strong organizational skills with the ability to self-manage tasks with minimal supervision.
    • Insight into infrastructure technologies and standards, including Cloud SaaS platforms, on-premise hosting, and networking.
  • Additional Requirements:
    • Awareness of finance and budget control principles.

by Carl Trinidad

Prior Authorization Staff

The Prior Authorization Staff plays a crucial role in ensuring timely and accurate authorization for patient infusions. This position requires meticulous attention to detail, effective communication skills, and a commitment to patient advocacy. The successful candidate will be responsible for submitting clinical information, following up on denials, coordinating with pharmacies, and monitoring infusion schedules to ensure all necessary authorizations are in place.

Job Details:

  • Work from Home
  • 08:00 AM - 05:00 PM EST (08:00 PM - 05:00 AM Manila Time)

    Responsibilities:

    • Submit accurate clinical information to obtain prior authorization for patient infusions.
    • Follow up on denials by submitting appeals and scheduling peer-to-peer discussions when necessary.
    • Review and submit prescriptions to pharmacies in accordance with prior authorization requirements.
    • Monitor infusion schedules and confirm that all required authorizations are on file prior to patient appointments.
    • Collaborate with healthcare providers and insurance companies to ensure seamless authorization processes.
    • Utilize CoverMyMeds software efficiently to streamline prior authorization procedures and enhance productivity.
    • Maintain detailed records of authorization activities and communicate updates to relevant stakeholders as needed.

    Qualifications:

    • Previous experience in medical prior authorization is required.
    • Familiarity with CoverMyMeds software is advantageous.
    • Strong organizational skills and attention to detail are essential.
    • Excellent communication and interpersonal abilities.
    • Ability to work independently and prioritize tasks effectively.
    • Knowledge of healthcare regulations and insurance policies related to prior authorization processes.

    by Carl Trinidad

    Prior Authorization Specialist

    Job Summary:

    We are seeking a detail-oriented and experienced Prior Authorization Specialist to join our growing team. In this role, you will be responsible for verifying insurance eligibility, obtaining prior authorization for medical services, and ensuring that all necessary documentation is in place for accurate billing. The successful candidate will possess excellent communication and organizational skills, as well as the ability to work independently and as part of a team.

    Job Details:

    • Prior Authorization Specialist
    • Work from home
    • Monday to Friday | 8 PM to 5 AM Manila Time
    • *Following US Holidays

    Responsibilities:

    • Verify insurance eligibility and benefits for patients, ensuring all information is accurate and up to date.
    • Obtain prior authorizations for medical services, working closely with healthcare providers, insurance companies, and patients.
    • Maintain thorough and accurate records of all prior authorization requests, approvals, and denials.
    • Communicate effectively with healthcare providers, patients, and insurance companies to resolve any issues related to prior authorizations and insurance verification.
    • Monitor and track prior authorization statuses, following up as needed to ensure timely processing and approval.
    • Collaborate with other team members, including medical billers and coders, to ensure efficient and accurate billing processes.
    • Stay informed on the latest changes and updates to insurance policies, procedures, and regulations, applying this knowledge to the prior authorization process.

    Qualifications:

    • Minimum of 2 years experience in medical insurance verification, prior authorization, or a related role
    • Familiarity with medical terminology, diagnostic codes (ICD-10), and procedure codes (CPT)
    • Knowledge of insurance policies, procedures, and regulations, including Medicare, Medicaid, and private insurance companies
    • Strong computer skills, including proficiency in Microsoft Office Suite.
    • Excellent verbal and written communication skills, with the ability to effectively communicate with healthcare providers, patients, and insurance companies.
    • Strong organizational skills and attention to detail, with the ability to manage multiple tasks and prioritize effectively.
    • Ability to work independently and as part of a team in a fast-paced, deadline-driven environment.
    • Experience working with electronic health record (EHR) systems, medical billing software, and insurance verification tools.

    by Carl Trinidad