Work Scope:

1.      • Renders basic nursing care such as, first-aid treatment, wound dressing, etc.
2.      • Conducts initial medical assessment of member through vital signs-taking prior to actual consult with the         Retainer Physician.
3.      • Assists the Corporate Retainer Physician when performing physical examination.
4.      • Monitors and maintains records of daily consultations and work clearances.
5.      • Dispenses over-the-counter medicines provided by the account.

Credentials:

•      • Must be a registered nurse with active PRC license
•      • Preferably with training in Basic Life Support (BLS), First Aid and IVT
•      • Must have a Basic Occupational Safety and Health (BOSH)Certification
•      • Experience in regulatory compliance is an advantage
•      • Must be able to work independently, possess high sense of responsibility, good judgment and decision              making skills.

Work Scope:

1.      • Facilitates member’s availment
2.      • Screens and assess coverage or non-coverage of availment (for readily-coverage or non-coverage cases.)
3.      • Grants coverage based on the set approval limits per member according to member’s benefit program per             Service agreement (SA) / Consolidated Sales Documentation (CSD)

Credentials:

•      • Candidate must be a graduate of Bachelor degree in Nursing
•      • Preferably a Registered Nurse
•      • At least with 2 years working experience in Hospital setting
•      • Applicants  must be willing to work on a shifting schedule

Work Scope:

1.      • Utilizes staffing models for new or adjusted forecasted assumptions
2.      • Perform analysis to validate process compliance and provide trend and/early warning analysis
3.      • Prepares presentation materials of finalized statistical reports to the AVP and VP for Operation

Credentials:

•      • Candidate must be a graduate of Bachelor’s Degree in Information Technology or any related course.
• •      • Preferably with 1 to 2 years experienced specializing in Customer Service
  •      • Advance in Microsoft Excel
  •      • Team player and willing to work on a minimum supervision

  • Willing to work ASAP

Work Scope:

1.      • Generates / expands sales revenues from existing portfolio of accounts (renewal business) and manages             the accounts to ensure customer retention.
2.      • Achieves the sales target based on assigned accounts
3.      • Handles brokers and agents’ performance and quotas

Credentials:

•      • Candidate must be a graduate of any four (4) year course
• • •      • Must exhibit excellent sales aptitude, negotiation and presentation skills
    •      • Must be self-motivated, independent and competitive
    •      • Should have the ability to deal with different types of people
    •      • Strong written and communication skills
    •      • Highly proficient in Microsoft office

     

Work Scope:

1.      • Generates leads through Cold calls, Referral and Saturation per Area assigned.
   1.      • Acquire new business corporate accounts with Maxicare Plus or Corporate Program.

   • Discuss and presents proposal to prospect clients.

Credentials:

•      • Candidate must be a graduate of any four (4) year course
• • • •      • Must exhibit excellent sales aptitude, negotiation and presentation skills
      •      • Must be self-motivated, independent and competitive
      •      • Should have the ability to deal with different types of people
      •      • Strong written and communication skills

      • Highly proficient in Microsoft office

Work Scope:

1.      • Manages consumer and corporate account to ensure its renewal to achieve set sales target.
   1.      • Ensures that the terms & conditions of the contract of the client are properly & accurately implemented

   • Conducts timely visit based on account size to provide utilization and concern handing report to the                       accounts.

Credentials:

•      • Candidate must be a graduate of any four (4) year course
  •      • Must exhibit excellent sales aptitude, negotiation and presentation skills
  •      • Must be self-motivated, independent and competitive
  •      • Should have the ability to deal with different types of people
  •      • Strong written and communication skills

  • Highly proficient in Microsoft office

Work Scope:

1.      • Achieves 100% of assigned business target
   1.      • Submits and provides baseline information on industries assigned.
   2.      • Provides client information and updates & customer feedback to the BDM.

   • Monitors assigned accounts and leads on a monthly basis, together with the required information on

2.         industry reports.

Credentials:

•      • Candidate must be a graduate of any four (4) year course

•      • Must exhibit excellent sales aptitude, negotiation and presentation skills
•      • Must be self-motivated, independent and competitive
•      • Should have the ability to deal with different types of people
•      • Strong written and communication skills

• Highly proficient in Microsoft office

Work Scope:

1.       • Conducts renewal negotiations with the Intermediary clients
2.      • Evaluates, Analyses & Presents Utilization Report to Client periodically (Monthly, Quarterly, Semi-                       Annual, Annual)
3.      • Conducts client’ healthcare needs analysis and provides solutions to clients’ healthcare need

Credentials:

•      • Candidate must be a graduate of any four (4) year course
•      • Must exhibit excellent sales aptitude, negotiation and presentation skills
•      • Must be self-motivated, independent and competitive
•      • Should have the ability to deal with different types of people
•      • Strong written and communication skills

• Highly proficient in Microsoft office

Work Scope:

1.       • Maintains and updates schedules for Accounts Payable, Miscellaneous Deposits, Provider Deposits and             other related accounts.

1.       • Reconciles the accounts and recommends adjusting entries as deemed necessary.

• Monitors Disbursement’s application of payment based on Unapplied Claims Reports.

Credentials:

• •      • Candidate must be a graduate of Bachelor’s degree in  Accountancy
  •      • Certified Public Accountant
  •      • At least 1 year working experience in related field is required in this position
  •      • With effective written and oral communication and strong analytical skills

  • Knowledgeable in Microsoft Excel

Work Scope:

1.       • Monitors hospital daily incurred running bills and periodically updates the patient.

1.       • Ensures adherence to given authority limits and proper observance of pre-defined policies and                         procedures

• Negotiates initially balance billing concerns otherwise elevates to Roving Supervisor and/or Provider                Relations Officer (PRO)

Credentials:

• • •      • Candidate must be a graduate of Bachelor’s degree in Nursing or any medical allied course
    •      • Willing to travel and work on extended hours
    •      • Has good communication skills
    •      • Must be able to work independently, possess high sense of responsibility, good judgment and decision             making skills.

    • Proficient in Microsoft open office

Work Scope:

1.       • Participate in all planning phase initiatives such as research, FGD and other development requirements.
2.       • Come up with scholarly product recommendations responsive to market needs and opportunities.
3.       • Manage day-to-day progress of product development, liaises with other departments and external parties          involved.
4.       • Develop and maintain the list of market requirements for product.

• Extend direction and expertise to other departments and assist in product function & service trainings.

Credentials:

• • •      • Graduate must be a graduate of Bachelor’s degree in Business Studies , Management, Marketing or any            related course
  •      • At least with 2 years’ experience in the related field is required doe this position
  •      • Must have experience in Product Management
  •      • Has good communication skills

Work Scope:

1.       • Assists the patients in their line-up via the online queuing system.

1.       • Thoroughly screens and assesses coverage or non-coverage of availments.
2.       • Encodes in the system manual LOAs created while the member is availing during unavoidable                               circumstances such as system downtime, power failure and calamities.

Credentials:

•      •  Candidate must be a graduate of Bachelor’s degree in Nursing or any medical allied course
•      •  Fresh graduates are welcome
•      •  Willing to travel and work on extended hours
•      •  Has good communication skills

• Willing to be assigned in Primary Care Clinics

Work Scope:

1.       • Facilitates out-patient availments

1.       • Assists the patients in their line-up via the online queuing system.
2.       •Thoroughly screens and assesses coverage or non-coverage of availments.

Credentials:

•      •  Must be a graduate of Bachelor’s degree in Nursing or any medical allied course
  •      •  Fresh graduates are welcome
  •      •  Willing to travel and work on extended hours
  •      •  Has good communication skills

  • Willing to be assigned in Primary Care Clinics

Work Scope:

1.       • Answers medical inquiries from different units or departments such as Contact Canter, Clinic Operations         & Outpatient Services, Inpatient Services, Claims, Actuarial and Underwriting, Sales & Marketing.

1.       • Recommends cases for approval or disapproval based on expert medical opinion, medical references or            journals, availment guidelines and benefit plans.
2.       • Recommends professional fees of affiliated physicians and instrument fees based on Maxicare rates or             Relative Value Scale and existing guidelines or benchmarked rates respectively.

Credentials:

•      •  Must be a graduate of Medicine
  • •      •  Preferably an Internal Medicine
    •      •  Must be willing to work full time
    •      •  Must be knowledgeable in Microsoft Powerpoint, Excel and Word

    •  Must be willing to work on extended hours

Work Scope:

1.      • Analyses the periodic utilization data of prioritized corporate accounts, such as large, jumbo and super-            jumbo corporate accounts, and determines the drivers of utilization costs, top availers, type of availments,        top diseases and top providers.
2.      • Formulates strategies and recommendations to control and decrease healthcare utilization costs of the               corporate accounts.
3.      • Consolidates both off-site and on-site utilization review reports from the annual check-Up (ACU), Health         & Wellness Unit and Corporate Clinics Unit.

Credentials:

•      • Must be a graduate of Medicine
• •      • Preferably a General Practitioner
  •      • Must be willing to work full time
  •      • Must be knowledgeable in Microsoft Powerpoint, Excel and Word

  • Must be willing to work on extended hours

1. Work Scope:

   1. 1.      • Facilitates the mobile annual check-up of corporate accounts as follows: (Refer to ACU Policies Procedure)
      2.      • Decks and schedules the account with a mobile ACU provider.

      • Conducts the pre-ACU meeting with the ACU provider and corporate account.

   Credentials:

   •      • Must be a graduate of Bachelor’s degree in Nursing or any medical allied course
   • • •      • Fresh graduates are welcome
       •      • Willing to travel and work on extended hours
       •      • Has good communication skills

       • Must be knowledgeable in Microsoft open office

Work Scope:

1.      • Assigns a suitable ECU provider for the member after validation of membership eligibility,              ECU packages, tests and procedures.
2.      • Sends the confirmation letter to the member within the turnaround time of 24 hours upon receipt of the         ECU request form.
3.      • Sends the letter of authorization (LOA) to the ECU provider within the turnaround time of two (2) days         prior to the scheduled date of ECU.

Credentials:

•      • Must be a graduate of Bachelor’s degree in Nursing or any medical allied course
• •      • Fresh graduates are welcome
  • •      • Willing to travel and work on extended hours
    •      • Has good communication skills

    • Must be knowledgeable in Microsoft open office

Work Scope:

1.      • Strategizes and plans out tasks for all PR Officers in his/her area.
2. 1.      • Trouble shoots problems, concerns, issues and negative feedbacks coming from members, providers and           doctors
   2.      • Analyses problems that run across areas and provide accurate assessments to come up with the        appropriate solutions.

   • Evaluates and recommends approval /disapproval of stale claims

Credentials:

•      • Must be a graduate of Medicine
• • •      • Preferably a General Practitioner
    •      • Must be willing to work full time
    •      • Must be knowledgeable in Microsoft Powerpoint, Excel and Word

    • Must be willing to work on extended hours

Work Scope:

1. 1. 1.      • Evaluates the application of new providers in terms of completeness and validity of requirements.
      2.      • Performs ocular inspection of provider facility.
      3.      • Reviews the submitted proposal of rates.
      4.      • Drafts the contracts for new providers as well as those for renewal.

      • Reports changes requested by the providers to the management for approval.

Credentials:

•      • Must be a Graduate of BS Nursing or any medical allied course
• • • •      • Willing to travel and work on extended hours
      •      • Has good communication skills
      •      • Has good presentation and negotiation skills

      • Must be knowledgeable in Microsoft open office

Work Scope:

1. 1. 1.      • Processes, computes and analyses initial and revised quotation requests from Sales and existing renewing        accounts.
      2. 1.      • Endorses to Supervisor processed initial and revised quotation request for validation and approval.

         • Escalates for approval to higher officer/s the quotations and benefits beyond limit of Supervisor

Credentials:

•      • Must be a graduate of Bachelor’s degree in Actuarial Science, Statistics or any related course
• • • •      • With at least 1 year of relevant work experience
      • •      • With advance mathematical or financial aptitude, analytical and problem solving skills
        •      • HMO experience is an advantage

        • Advance knowledge in MS Excel

Work Scope:

1.      • Validates and checks computations submitted by the Actuarial Assistant on quotation requests.
2.      • Analyses, reviews and approves quotations based on authorized limits.

• Escalates to Assistant Manager or higher officer quotation requests above and beyond the authorized limits          and other actuarial concerns

Credentials:

•      • Must be a graduate of Bachelor’s degree in Actuarial Science, Statistics or any related course
• • • • •      • Has strong background in in creating, developing pricing models for new product
        •      • HMO experience is an advantage

        • Responsible in providing analytical and actuarial support services to the team