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DE031312 - Health Clinical Services Assoc Manager

Talentmate

Philippines

9th January 2026

2601-18702-1358

Job Description

ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE--- POSITION TITLE: Health Clinical Services Assoc Manager WORK SETUP: RTO Responsibilities:

Oversees staff and Team Leads in either Utilization Management (UM) and/or appeals whose primary duties may include: O Conducts pre-service, concurrent/continue stay and retrospective service requests received via telephone, facsimile, portal, email and/or writing O Perform out of network reviews O Determine the appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts O Outbound calls to the provider may be required to gather additional information as needed to perform clinical review

Provides leadership, oversight, guidance and mentor staff and team leads with making clinical decisions, which have major day-to-day impact in area of responsibility, and may influence direction of other areas.

Allocates resources and responsibilities across team to deliver business results and develop team members.

Manages and ensures consistent application of human resource processes including career/professional development support, coaching and performance management within area of responsibility.

Initiates and promotes continuous improvement programs across sphere of influence.

Responsible for maintaining contractual, regulatory and accreditation compliance by knowing, understanding, correctly interpreting, and accurately applying requirements, regulations, and standards. Reports suspected or confirmed issues timely as the situation warrants to the Compli OTHERS Project Shift Schedule: Night Shift Project Rest Day: Weekends Project/Team Location: Gateway Tower 2

SKILL AND QUALIFICATIONS

At least 7 years relevant experience and 5 years supervisory- (Supervisory experience can be a combination of both BPO and clinical)

Holds current and unrestricted US Registered Nurse license. No state specific RN licensure required.

BPO experience should be any account (Health account experience is only a plus, but not required)

Excellent written and verbal communication skills in English

Strong proficiency in Microsoft Excel, Word and PPT

Strong customer service focus

Ability to empathize

Prioritizing customer needs

Listening, patience & action oriented

Good understanding of phone etiquette

Job Details

Role Level:	Mid-Level	Work Type:	Full-Time
Country:	Philippines	City:	Quezon City National Capital Region
Company Website:	https://www.accenture.com/ph-en	Job Function:	Healthcare & Medical Services
Company Industry/ Sector:	Software Development

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