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PHRN Supervisor - Large Claims Review

AT UnitedHealth Group
UnitedHealth Group

PHRN Supervisor - Large Claims Review

Pasay, Philippines

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Underwriting Consultant will analyze health benefit plan characteristics and assess risks as to frequency and potential severity of losses of clients.

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This individual will analyze health benefit plan characteristics and assess risks as to frequency and potential severity of losses of clients. Will utilize established underwriting criteria and policies to provide proper rating methodologies. Will build and maintain models to assist in the economic analysis of market alternatives. The Underwriting Consultant will evaluate and recommend alternative pricing options and plan design changes based on economic analysis and trends. This individual will also prepare financial modeling for reserve calculation, budget calculation, and other ongoing reviews that directly aligns with client strategies. They will validate renewals and request for proposals for accuracy including utilization & experience reporting.

Primary Responsibility:

  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

  • 7+ years Healthcare Insurance Underwriting experience
  • 5+ years of Management experience
  • Experience in dealing with US Stakeholders including Business Reviews & Capability assessment
  • Proven good analytical skills
  • Solid written and verbal communication skills
  • Flexible working in Evening/Night Shifts

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone - of every race, gender, sexuality, age, location and income - deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Optum is a drug-free workplace. © 2025 Optum Global Solutions (Philippines) Inc. All rights reserved.

Client-provided location(s): Makati City, Metro Manila, Philippines
Job ID: UHG-2296486
Employment Type: Full Time

Perks and Benefits

  • Health and Wellness

    • HSA
    • On-Site Gym
    • HSA With Employer Contribution
    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
  • Parental Benefits

    • Non-Birth Parent or Paternity Leave
    • Birth Parent or Maternity Leave
  • Work Flexibility

    • Remote Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
  • Vacation and Time Off

    • Leave of Absence
    • Personal/Sick Days
    • Paid Holidays
    • Paid Vacation
  • Financial and Retirement

    • Relocation Assistance
    • Performance Bonus
    • Stock Purchase Program
    • 401(K) With Company Matching
    • 401(K)
  • Professional Development

    • Promote From Within
    • Shadowing Opportunities
    • Access to Online Courses
    • Tuition Reimbursement
  • Diversity and Inclusion

    • Diversity, Equity, and Inclusion Program

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