Clinical Healthcare BPO Consultant

About the role

The Clinical Healthcare BPO Consultant will provide expert consultancy to insurance and healthcare clients, helping to establish and optimise clinical, bill‑review, and insurance practice operations. This role involves close collaboration with clients, internal teams, and stakeholders to deliver strategic solutions that improve service delivery and business outcomes.

Key responsibilities

• Deliver consultancy services to set up and enhance clinical, bill‑review, and insurance practices for insurance and healthcare verticals.
• Maintain effective communication with clients and team members, understand needs, resolve issues, and exceed expectations.
• Participate in RFPs, client proposals, meetings, and sales calls as directed.
• Develop data‑driven strategies and recommendations to impact business performance.
• Identify training needs and equip staff with essential skills for program success.
• Provide guidance on system tools and operational procedures to improve service delivery.
• Collaborate regularly with stakeholders to create and refine strategies.
• Ensure process compliance across team members, partners, and third‑party providers, and suggest improvements.

Required profile

• Bachelor’s degree in a related field.
• Registered Nurse licence in the Philippines and the United States.
• Minimum 15 years of industry experience, including 2‑3 years in a director‑level role.
• Proven experience in healthcare, casualty, or workers’ compensation domains, managing intake, clinical utilization review, nurse reviews, and medical provider call centre operations.
• Strong analytical, time‑management, and leadership abilities.

Required skills

• Microsoft Office applications

What we offer

• Opportunity to lead high‑impact consultancy projects in a dynamic BPO environment.
• Collaborative work culture with professional growth prospects.