Operations Manager – Utilization Management

Epergne Solutions

Full‑time

National Capital Region

Negotiable

Advanced (5-10 yrs)

Location: Manila, Philippines

Experience: 10+ Years

Job Title

Operations Manager – Utilization Management

Roles & Responsibilities

• Oversee daily Utilization Management (UM) operations for preservice, retrospective, and concurrent review activities.
• Ensure compliance with SLAs, policies, medical guidelines, and regulatory requirements.
• Lead team performance management, staffing accuracy, and resource allocation.
• Drive process improvement initiatives to enhance operational efficiency and service quality.
• Collaborate with internal stakeholders to support smooth operational delivery.
• Ensure adherence to HIPAA and all applicable regulatory standards.

Skills & Requirements

• Bachelor’s Degree in Nursing.
• Active US Regis...