EXL

Assistant Manager - Utilization Manager Medical Case Build PH

In short

This role leads a Utilization Management case team, mentoring staff on practice standards, coaching performance, and overseeing day-to-day operations to meet KPIs and compliance requirements. It is posted by EXL, a business process outsourcing/services company, for its Medical Case Build operations in the Philippines. The role requires client interaction at the supervisor level and strong team leadership and quality-oversight skills. Candidates must be a registered nurse with at least 1 year of clinical and/or utilization management experience.

Role/ Responsibilities
•Serves as a content model expert and mentor to the team regarding practice standards, quality of interventions, problem resolution and critical thinking
•Monitor transactions with an ongoing basis and take corrective steps where necessary or make incremental improvements
•Assist new hires such that they are productive on the floor in the shortest possible time frame
•Provides inputs on process and system to the team members
•Client Interaction, where required at the level of Supervisors
•Ensure compliance with internal policies and procedures, external regulations and information security standards
•Oversee and manage day-to-day operations to ensure all metrics are met, revenue are maximized and monitor team performance as per agreed KPIs
•Communicates productivity expectations, balance workload (e.g., daily team meetings to discuss new updates), monitor efficiency and initiate control measures to minimize variances in workload over time
•Monitor transactions with an ongoing basis and take corrective steps where necessary or make incremental improvements
•Provide coaching and feedback to team members to enable them to improve their performance
•Ensures the team's understanding and use of information system capability and functionality
•Provide inputs on process and system to the team members
•Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance
•Ensures compliance with internal policies and procedures, external regulations and information security standards
•Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
•Ability to work in a continually challenging environment
•Good written and verbal communication skills
•Good leadership skills
•Customer Service oriented
•Quality oriented
•Empathy for effective on the job coaching and feedback
•Understanding of end-to-end processes and appreciation of critical parameters
•Registered nurse with at least 1 year of clinical and/or UM experience
•Ability to interpret assignments and understand department strategy
•Adaptable with the ability to thrive in a fast paced environment with strong attention to detail
•Capacity to multi-task, including use of multiple computer applications simultaneously
•Effective verbal and listening communication skills
•Experience making decisions and working independently with little supervision
•Must be passionate about contributing to an organization focused on continuously improving consumer experiences

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