Job Description

We’re looking for a USRN Care Manager to join our Insurance Operations team at MBPS. In this role, you are expected to evaluate medical documentation and claim information against policy terms and conditions to determine eligibility for insurance benefits. Interprets policy language, analyzes medical evidence, and makes accurate claim decisions while ensuring compliance with contractual and regulatory requirements.

Position Responsibilities:

• Assess clinical needs and determine initial eligibility for long-term care benefits using clinical evidence and established guidelines.
• Review onsite/virtual assessments, functional and cognitive screening results, and supporting documentation to make benefit eligibility decisions.
• Monitor ongoing claims, particularly those with high-risk activity, and conduct clinical follow-ups in accordance with current protocols.
• Collaborate with senior care management and cross-functional teams to ensure accurate claim decisions and provide excellent customer service.
• Maintain up-to-date knowledge of clinical protocols and guidelines by completing required training programs.
• Participate in regular meetings, one-on-ones, and other team activities to support operational goals and continuous improvement.

Required Qualifications:

• Active Philippine Registered Nurse (PHRN) and US Registered Nurse (USRN) licenses, with the USRN license valid in any U.S. state.
• 5+ years of nursing experience, preferably in geriatrics, long-term care, chronic illness management, or related clinical settings.
• Experience within the Long-Term Care industry is highly desirable; geriatric nursing experience is preferred.
• Bachelor’s degree in Nursing (BSN).
• Amenable for fixed night shift schedule

Preferred Qualifications:

• Proficiency in Microsoft Office applications and the ability to quickly learn new systems and technologies; excellent written and verbal communication skills
• Strong decision-making, assessment, and clinical judgment skills, with the ability to work independently and within multidisciplinary teams.

When you join our team:

• We’ll empower you to learn and grow the career you want.
• We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
• As part of our global team, we’ll support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact hr@manulife.com

Hybrid