Utilization Review Nurse

Role Overview: We are seeking a skilled Utilization Management/Review Nurse to join our team. This role is essential in ensuring patients receive appropriate, timely, and cost-effective care by reviewing medical records, treatment plans, and healthcare resource utilization. Key Responsibilities: Conduct concurrent and retrospective reviews of patient...

Role Overview: We are looking for a detail-oriented Utilization Review Coordinator/Medical Management Resolution Specialist to join our team. The ideal candidate will have experience in medical coding within the US healthcare system, whether certified or non-certified, and a strong background in medical management resolution. Key Responsibilities Collect,...

The Clinical Bill Review Nurse is responsible for reviewing medical bills and associated documentation to ensure accuracy, medical necessity, and compliance with workers' compensation guidelines. This role supports payment integrity by identifying inappropriate charges, ensuring adherence to jurisdictional fee schedules, and applying clinical expertise to...

Overview We are seeking a qualified Registered Nurse for our -voice account - BPO setting. This is a full-time position that offers a dynamic and supportive work environment. What you'll be doing You will extract and summarize relevant clinical information from patient records to support healthcare analytics, research, and quality improvement efforts. ...

WE'RE HIRING! – Prior-Authorization Nurse USRN – Pioneer Account Location: Ortigas (Onsite) Company: VISAYA Be part of a pioneer team supporting patient care through prior-authorization and utilization review services. Qualifications: Graduate of BS Nursing with an active USRN license At least 3–5 years of solid experience in: Utilization Review...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description We are seeking a qualified Registered Nurse for our -voice account - BPO setting. At least one(1) year hospital or direct patient care is needed to join our team in Quezon City. This is a full-time position that offers a dynamic and supportive work environment. What you'll be doing You...

On-site - Quezon City 1-3 Yrs Exp Bachelor Full-time Job Description We are seeking a qualified Registered Nurse for our -voice account - BPO setting. At least one(1) year hospital or direct patient care is needed to join our team in Quezon City. This is a full-time position that offers a dynamic and supportive work environment. What you'll be doing You...

Licensed Nurse Responsible for the delivery of patient care through the utilization of the nursing process and competency-based nursing practice standards. He/ she is responsible for managing records, supplies, and equipment. He/ she provides health education to patients and families, collaborates with other professional disciplines to ensure effective...

JOB TITLE: Head NurseJOB QUALIFICATIONS:Graduate of Bachelor of Science in Nursing from an accredited College of NursingPassed the Nursing Licensure ExamMust be a Renal Nurse Association of the Philippines (RENAP) memberMust be a Certified Nephrology Nurse by RENAPMust have two (2) years clinical experience as Renal NurseMust have formal dialysis...

Summary Of Primary Job Responsibilities With critical medical thinking skills and good bedside manner Provide basic health care administering first aid where needed and evaluating employees' overall health Attend to and follow up all medical-related concerns. Administer first aid/nursing intervention to employees. Assist patient to nearest hospital...