NTT DATA - Philippines, Health and Beauty

Seeking a detail-oriented **Clinical Reviewer Specialist** in **Manila, Philippines** to conduct medical necessity reviews for appeals. This role requires an active **RN license** and expertise in **NCQA** and **Medicaid regulations**. You will analyze clinical data, collaborate with Medical Dire...

We are seeking a BPO Clinical Review Specialist in Manila to perform clinical reviews for appeals processing. This role requires an RN with 1-3 years of experience in utilization management and knowledge of NCQA/Medicaid regulations. You will analyze medical records, prepare case reviews for Medi...