Utilization Review Nurse

4 weeks ago


Cebu City, Philippines Nezda Global Full time

Nezda is currently hiring for Utilization Review Nurse (USRN).

Qualifications:
Active USRN and PHRN License
With at least 1 Year Clinical or Hospital Experience

Job Description:
Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
Responsible for conducting medical management review activities which require the review of clinical information against client specific criteria as noted above but excludes denial determinations.
Consult with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.

Location: Cebu
Salary: P50,000 to P70,000

WAYS TO APPLY:
️ Send your resume to: .
️ Apply through the link:

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