WNS Global Services

Role Description The Site CSR is primarily responsible for making outbound calls to and accepting inbound calls from healthcare providers to answer questions about the requirement to participate, assistance with registration and login, assessment completion and questions regarding scoring results. Qualifications - Must have an active PRC License - 2 years bedside / clinical experience - Preferably with 6 months BPO healthcare account experience - Excellent communication skills Benefits - Structured career path - Growing and expanding team – more internal career progression opportunities for all - Safe work environment - Free HMO coverage from day 1, including your domestic partner - Skills training opportunities - Paid leaves - Annual appraisal

Role Description As a senior financial analyst on the Financial Planning & Analysis (FP&A) team, you will work with other departments (operations, accounting, strategy, etc.) to drive business results and perform key analytical work to understand our rapidly growing and evolving business and forecast future results. - Develop and analyze key performance indicators to support revenue growth and cost-saving initiatives - Create and maintain financial models to explain past results and forecast future performance - Analyze budget-actual variances of monthly, quarterly, and annual results to explain organization performance - Support budget/forecast preparation working with various departments across the company - Provide supporting schedules for monthly financial reporting package for the Board - Assist with M&A due diligence on target acquisitions - Work as a team player and assist with other projects and assignments as needed Qualifications - Bachelor’s degree in Accounting, Finance, or Business required; STEM preferred - Two (2) years of experience in a Finance or Accounting position required; Three (3) years preferred Requirements - Intermediate knowledge of Excel required, advanced knowledge preferred (examples include: Pivot Tables, Sumifs, Xlookup, Index Match, conditional formatting, etc.) - Knowledge of financial modeling - Basic understanding of GAAP - Knowledge of business intelligence software preferred (PowerBI, Power Query, Alteryx or similar tool) - Solid problem solving and analytical skills - Strong attention to detail (tie-outs & checking figures) - Proven ability to work both independently and collaboratively with different levels of employees - Ability to communicate effectively across the organization - Good customer service skills - Knowledge of SQL preferred (or willingness to learn) Physical Demands and Work Environment - May be required to stand; reach with hands and arms, stoop and kneel - May be required to sit for long periods of time - May be required to lift, carry, push, pull or move up to 15 pounds - May be required to travel overnight occasionally - Typically working remotely from home and/or in an office environment

Company Description WNS Healthhelp, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption. Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact. Job Description - Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including - - Admission reviews - Continued stay reviews - Transitional care reviews (Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Acute Care Hospital) - Related follow-up activities and documentation updates - Engage in clinical collaboration with attending physicians, hospitalists, and care teams to obtain clinical information, discuss medical necessity determinations, and support appropriate level-of-care decisions - Capable of communicating clinical rationale to attending physicians, hospitalists, and facility staff during real-time concurrent review interactions - Facilitates resolution of escalated cases that may require special handling - Refers cases to a Physician Reviewer or to a Specialty Program Medical Director per guidelines - Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes - Maintains written documentation according to HealthHelp’s documentation policy - Has a working knowledge of regulations, accreditation requirements, and payer-specific guidelines by state and market; applies InterQual level-of-care criteria and applicable HealthHelp or client medical policies to inpatient review determinations - Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs - Complies with URAC & NCQA standards or other requisite regulating bodies - Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management - Keeps current with regulation changes as provided by Compliance Department and Nursing Management - Functions as subject matter expert to support Compliance Department initiatives and updates - Collects and enters confidential information ensuring the highest level of confidentiality in all areas - Performs clinical intake and reviews cases according to the policies and procedures of HealthHelp for markets and cases requiring expedited turnaround times - Maintains availability to support concurrent review coverage requirements, which may include non-standard business hours, weekends, or holidays as determined by client contractual obligations and regulatory review timeframes - Ability to perform multiple tasks simultaneously, prioritize projects, work independently under pressure, and meet critical deadlines - Appropriately identifies and refers quality issues to UM Leadership - Collaborates with client personnel to resolve customer concerns - Provides quality customer service through interaction with providers, administrative staff, and others - Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others - Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy - Participates in the HealthHelp Quality Management Program, as required - Performs other related duties and projects as assigned to meet business needs Qualifications - RN graduate from an accredited school of nursing (BSN preferred) - Current, active unrestricted RN license in the state or territory of the U.S. (USRN equivalent) - Two (2) years of experience in an acute care setting, required - Two (2) years of inpatient clinical nursing, utilization management, concurrent experience required - Experience with InterQual or similar evidence-based clinical decision support criteria, preferred - Willingness to complete and maintain InterQual certification and ongoing competency requirements - Familiarity with inpatient level-of-care criteria, observation versus inpatient status determinations, and transitional care planning, - Working knowledge of medical necessity criteria, level-of-care determination standards, and payer-specific utilization review requirements - Knowledge of insurance terminology - Experience working with state and federal regulatory and compliance standards, preferred - Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint), required - Good organizational and time management skills - Excellent written and verbal communication skills - Ability to utilize critical thinking skills - Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: 5/18/2026 Schedule: Monday- Friday 8hr. shift between 7AM - 5PM PST Location: Remote Benefits: Health, Dental, Vision, 401K, PTO Salary: $75,000/yr + quarterly bonus based on performance Equipment: Provided Compensation Disclosure The base salary range for this position is $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].

Company Description WNS Healthhelp, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption. Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact. Job Description - Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including - - Admission reviews - Continued stay reviews - Transitional care reviews (Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Acute Care Hospital) - Related follow-up activities and documentation updates - Engage in clinical collaboration with attending physicians, hospitalists, and care teams to obtain clinical information, discuss medical necessity determinations, and support appropriate level-of-care decisions - Capable of communicating clinical rationale to attending physicians, hospitalists, and facility staff during real-time concurrent review interactions - Facilitates resolution of escalated cases that may require special handling - Refers cases to a Physician Reviewer or to a Specialty Program Medical Director per guidelines - Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes - Maintains written documentation according to HealthHelp’s documentation policy - Has a working knowledge of regulations, accreditation requirements, and payer-specific guidelines by state and market; applies InterQual level-of-care criteria and applicable HealthHelp or client medical policies to inpatient review determinations - Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs - Complies with URAC & NCQA standards or other requisite regulating bodies - Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management - Keeps current with regulation changes as provided by Compliance Department and Nursing Management - Functions as subject matter expert to support Compliance Department initiatives and updates - Collects and enters confidential information ensuring the highest level of confidentiality in all areas - Performs clinical intake and reviews cases according to the policies and procedures of HealthHelp for markets and cases requiring expedited turnaround times - Maintains availability to support concurrent review coverage requirements, which may include non-standard business hours, weekends, or holidays as determined by client contractual obligations and regulatory review timeframes - Ability to perform multiple tasks simultaneously, prioritize projects, work independently under pressure, and meet critical deadlines - Appropriately identifies and refers quality issues to UM Leadership - Collaborates with client personnel to resolve customer concerns - Provides quality customer service through interaction with providers, administrative staff, and others - Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others - Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy - Participates in the HealthHelp Quality Management Program, as required - Performs other related duties and projects as assigned to meet business needs Qualifications · - RN graduate from an accredited school of nursing (BSN preferred) - Current, active unrestricted RN license in the state or territory of the U.S. (USRN equivalent) - Two (2) years of experience in an acute care setting, required - Two (2) years of inpatient clinical nursing, utilization management, concurrent experience required - Experience with InterQual or similar evidence-based clinical decision support criteria, preferred - Willingness to complete and maintain InterQual certification and ongoing competency requirements - Familiarity with inpatient level-of-care criteria, observation versus inpatient status determinations, and transitional care planning, - Working knowledge of medical necessity criteria, level-of-care determination standards, and payer-specific utilization review requirements - Knowledge of insurance terminology - Experience working with state and federal regulatory and compliance standards, preferred - Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint), required - Good organizational and time management skills - Excellent written and verbal communication skills - Ability to utilize critical thinking skills - Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: 5/18/2026 Schedule: Monday- Friday 8hr. shift between 7AM - 5PM PST Location: Remote Benefits: Health, Dental, Vision, 401K, PTO Salary: $75,000/yr + quarterly bonus based on performance Equipment: Provided Compensation Disclosure The base salary range for this position is $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].

Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption.Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact. Job Description · Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including: · Admission reviews · Continued stay reviews · Transitional care reviews (Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Acute Care Hospital) · Related follow-up activities and documentation updates · Engage in clinical collaboration with attending physicians, hospitalists, and care teams to obtain clinical information, discuss medical necessity determinations, and support appropriate level-of-care decisions · Capable of communicating clinical rationale to attending physicians, hospitalists, and facility staff during real-time concurrent review interactions · Facilitates resolution of escalated cases that may require special handling · Refers cases to a Physician Reviewer or to a Specialty Program Medical Director per guidelines · Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes · Maintains written documentation according to HealthHelp’s documentation policy · Has a working knowledge of regulations, accreditation requirements, and payer-specific guidelines by state and market; applies InterQual level-of-care criteria and applicable HealthHelp or client medical policies to inpatient review determinations · Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs · Complies with URAC & NCQA standards or other requisite regulating bodies · Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management · Keeps current with regulation changes as provided by Compliance Department and Nursing Management · Functions as subject matter expert to support Compliance Department initiatives and updates · Collects and enters confidential information ensuring the highest level of confidentiality in all areas · Performs clinical intake and reviews cases according to the policies and procedures of HealthHelp for markets and cases requiring expedited turnaround times · Maintains availability to support concurrent review coverage requirements, which may include non-standard business hours, weekends, or holidays as determined by client contractual obligations and regulatory review timeframes · Ability to perform multiple tasks simultaneously, prioritize projects, work independently under pressure, and meet critical deadlines · Appropriately identifies and refers quality issues to UM Leadership · Collaborates with client personnel to resolve customer concerns · Provides quality customer service through interaction with providers, administrative staff, and others · Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others · Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy · Participates in the HealthHelp Quality Management Program, as required · Performs other related duties and projects as assigned to meet business needs Qualifications · RN graduate from an accredited school of nursing (BSN preferred) · Current, active unrestricted RN license in the state or territory of the U.S. (USRN equivalent) · Two (2) years of experience in an acute care setting, required · Two (2) years of inpatient clinical nursing, utilization management, concurrent experience required · Experience with InterQual or similar evidence-based clinical decision support criteria, preferred · Willingness to complete and maintain InterQual certification and ongoing competency requirements · Familiarity with inpatient level-of-care criteria, observation versus inpatient status determinations, and transitional care planning, preferred · Working knowledge of medical necessity criteria, level-of-care determination standards, and payer-specific utilization review requirements · Knowledge of insurance terminology · Experience working with state and federal regulatory and compliance standards, preferred · Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint), required · Good organizational and time management skills · Excellent written and verbal communication skills · Ability to utilize critical thinking skills · Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: 5/18/2026 Schedule: Monday- Friday 8hr. shift between 7AM-5PM PST Location: Remote Benefits: Health, Dental, Vision, 401K w/ 5% match, PTO etc. Salary: $75,000/yr + quarterly bonus based on production Equipment: Provided Compensation Disclosure The base salary range for this position is $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. Final compensation will be determined based on a variety of factors, including but not limited to the candidate’s experience, education, skillset, and location. • Geographic location • Overall professional experience • Directly relevant experience • Education and certifications • Industry knowledge and expertise • Skills and competencies In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].

Company Description WNS Healthhelp, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption. Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact. Job Description · Performs concurrent inpatient utilization review using InterQual criteria to determine if the request meets medical necessity criteria, including: · Admission reviews · Continued stay reviews · Transitional care reviews (Skilled Nursing Facility, Inpatient Rehabilitation Facility, Long-Term Acute Care Hospital) · Related follow-up activities and documentation updates · Engage in clinical collaboration with attending physicians, hospitalists, and care teams to obtain clinical information, discuss medical necessity determinations, and support appropriate level-of-care decisions · Capable of communicating clinical rationale to attending physicians, hospitalists, and facility staff during real-time concurrent review interactions · Facilitates resolution of escalated cases that may require special handling · Refers cases to a Physician Reviewer or to a Specialty Program Medical Director per guidelines · Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes · Maintains written documentation according to HealthHelp’s documentation policy · Has a working knowledge of regulations, accreditation requirements, and payer-specific guidelines by state and market; applies InterQual level-of-care criteria and applicable HealthHelp or client medical policies to inpatient review determinations · Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs · Complies with URAC & NCQA standards or other requisite regulating bodies · Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management · Keeps current with regulation changes as provided by Compliance Department and Nursing Management · Functions as subject matter expert to support Compliance Department initiatives and updates · Collects and enters confidential information ensuring the highest level of confidentiality in all areas · Performs clinical intake and reviews cases according to the policies and procedures of HealthHelp for markets and cases requiring expedited turnaround times · Maintains availability to support concurrent review coverage requirements, which may include non-standard business hours, weekends, or holidays as determined by client contractual obligations and regulatory review timeframes · Ability to perform multiple tasks simultaneously, prioritize projects, work independently under pressure, and meet critical deadlines · Appropriately identifies and refers quality issues to UM Leadership · Collaborates with client personnel to resolve customer concerns · Provides quality customer service through interaction with providers, administrative staff, and others · Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others · Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy · Participates in the HealthHelp Quality Management Program, as required · Performs other related duties and projects as assigned to meet business needs Qualifications · RN graduate from an accredited school of nursing (BSN preferred) · Current, active unrestricted RN license in the state or territory of the U.S. (USRN equivalent) · Two (2) years of experience in an acute care setting, required · Two (2) years of inpatient clinical nursing, utilization management, concurrent experience required · Experience with InterQual or similar evidence-based clinical decision support criteria, preferred · Willingness to complete and maintain InterQual certification and ongoing competency requirements · Familiarity with inpatient level-of-care criteria, observation versus inpatient status determinations, and transitional care planning, · Working knowledge of medical necessity criteria, level-of-care determination standards, and payer-specific utilization review requirements · Knowledge of insurance terminology · Experience working with state and federal regulatory and compliance standards, preferred · Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint), required · Good organizational and time management skills · Excellent written and verbal communication skills · Ability to utilize critical thinking skills · Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: 5/18/2026 Schedule: Monday- Friday 8hr. shift between 7AM - 5PM PST Location: Remote Benefits: Health, Dental, Vision, 401K, PTO Salary: $75,000/yr + quarterly bonus based on performance Equipment: Provided Compensation Disclosure The base salary range for this position is $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. Final compensation will be determined based on a variety of factors, including but not limited to the candidate’s experience, education, skillset, and location. • Geographic location • Overall professional experience • Directly relevant experience • Education and certifications • Industry knowledge and expertise • Skills and competencies In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].

Company Description HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization and care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment. HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth. Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp is headquartered in Houston, Texas. HealthHelp provides equal opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws. If you need assistance in completing this application due to a disability, please contact a member of the Talent Acquisition Group to request an accommodation or an alternative application process by emailing [email protected] Job Description • Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body. • Facilitates resolution of escalated cases that may require special handling. • Performs clinical reviews according to the policies and procedures of HealthHelp within the identified State and Federal or Client agreed upon timeframes. • Collaborates with client personnel to resolve customer concerns. • Appropriately identifies and refers quality issues to UM Leadership. • Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes. • Maintains written documentation according to HealthHelp’s documentation policy. • Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management. • Keeps current with regulation changes as provided by Compliance Department and Nursing Management. • Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs. • Provides quality customer service through interaction with providers, administrative staff, and others. • Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others. • Engages in phone conversations with ordering providers, members, internal staff, primary care physicians (PCPs), and rendering providers as necessary to facilitate the clinical review process and ensure appropriate care decisions. • Effectively utilizes various computer systems and software to manage cases and document reviews. • Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy. • Participates in the HealthHelp Quality Management Program, as required. • Adheres to both URAC & NCQA standards pertinent to their job description. • Ability to prioritize projects, work independently under pressure, and meet critical deadlines. • Capable of communicating clinical concepts to providers and staff based on guidelines. • Performs other related duties and projects as assigned to meet business needs. Qualifications • RN, LPN/LVN graduate from an accredited school of nursing • Current, active unrestricted RN, LPN/LVN license in the state or territory of the U.S. • Minimum of two (2) years experience in utilization review, case management, or clinical quality improvement • Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint) and ability to adapt to new healthcare specific software and systems, required • Experience working with state and federal regulatory and compliance standards, preferred • Working knowledge of National Coverage Determination (NCD) and Local Coverage Determination (LCD) • Knowledge of insurance terminology • Good organizational and time management skills • Excellent written and verbal communication skills • Ability to utilize critical thinking skills • Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: May 4th, 2026 Training Schedule (First 6 Weeks): Monday to Friday, 8:00 AM – 4:30 PM (CST) Regular Schedule After Training: 10:30amCST - 7:00pm CST Location: Remote Compensation Disclosure The base salary range for this position is $65,000 [LVN/LPN], $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. Final compensation will be determined based on a variety of factors, including but not limited to the candidate’s experience, education, skillset, and location. • Geographic location • Overall professional experience • Directly relevant experience • Education and certifications • Industry knowledge and expertise • Skills and competencies In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].

Company Description HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization and care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment. HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth. Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp is headquartered in Houston, Texas. HealthHelp provides equal opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws. If you need assistance in completing this application due to a disability, please contact a member of the Talent Acquisition Group to request an accommodation or an alternative application process by emailing [email protected] Job Description • Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body. • Facilitates resolution of escalated cases that may require special handling. • Performs clinical reviews according to the policies and procedures of HealthHelp within the identified State and Federal or Client agreed upon timeframes. • Collaborates with client personnel to resolve customer concerns. • Appropriately identifies and refers quality issues to UM Leadership. • Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes. • Maintains written documentation according to HealthHelp’s documentation policy. • Ensures consistency in implementation of policy, procedure, and regulatory requirements in collaboration with Nursing Management. • Keeps current with regulation changes as provided by Compliance Department and Nursing Management. • Adheres to all HIPAA, state, and federal regulations pertaining to the clinical programs. • Provides quality customer service through interaction with providers, administrative staff, and others. • Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others. • Engages in phone conversations with ordering providers, members, internal staff, primary care physicians (PCPs), and rendering providers as necessary to facilitate the clinical review process and ensure appropriate care decisions. • Effectively utilizes various computer systems and software to manage cases and document reviews. • Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy. • Participates in the HealthHelp Quality Management Program, as required. • Adheres to both URAC & NCQA standards pertinent to their job description. • Ability to prioritize projects, work independently under pressure, and meet critical deadlines. • Capable of communicating clinical concepts to providers and staff based on guidelines. • Performs other related duties and projects as assigned to meet business needs. Qualifications • RN, LPN/LVN graduate from an accredited school of nursing • Current, active unrestricted RN, LPN/LVN license in the state or territory of the U.S. • Minimum of two (2) years experience in utilization review, case management, or clinical quality improvement • Proficient technical skills in Microsoft Office (Word, Excel, and PowerPoint) and ability to adapt to new healthcare specific software and systems, required • Experience working with state and federal regulatory and compliance standards, preferred • Working knowledge of National Coverage Determination (NCD) and Local Coverage Determination (LCD) • Knowledge of insurance terminology • Good organizational and time management skills • Excellent written and verbal communication skills • Ability to utilize critical thinking skills • Highly motivated, self-starter who can work efficiently and independently, or as a team member Additional Information Start Date: May4th, 2026 Training Schedule (First 6 Weeks): Monday to Friday, 8:00 AM – 4:30 PM (CST) Regular Schedule After Training: 10:30am - 7:00pm CST Location: Remote Compensation Disclosure The base salary range for this position is $65,000 [LVN/LPN], $75,000 [RN] annually. This represents the base pay range that we reasonably expect to offer for this position. Final compensation will be determined based on a variety of factors, including but not limited to the candidate’s experience, education, skillset, and location. • Geographic location • Overall professional experience • Directly relevant experience • Education and certifications • Industry knowledge and expertise • Skills and competencies In addition to base pay, this role may be eligible for performance-based bonuses, incentive pay, or commissions, which are not included in the listed base salary range. WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois. Note: For complete compensation information, please refer to the job posting on our official careers page. Benefits Overview Our benefits package includes (but is not limited to): - Medical, dental, and vision insurance - Paid time off (PTO), holidays, and sick leave - 401(k) with company match or other retirement plan - Life and AD&D Insurance - Employee Assistance Program Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law. We also provide reasonable accommodations to individuals with disabilities and for sincerely held religious beliefs in all aspects of employment, including the application process. How to Apply Please submit your application, including a resume and optional cover letter, through our careers page or email to [email protected].