Utilization Review Nurse | UMR | PHRN | Pasay
3 weeks ago
Director Talent Acquisition at Access Healthcare Services We are seeking a highly skilled and detail-oriented PH Registered Nurse (PHRN) to join our team. The ideal candidate will have hands-on experience with InterQual , MCG , NCD , and LCD Guidelines Key Responsibilities Conduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria. Analyze patient records to determine the medical necessity and appropriateness of services. Collaborate with medical directors and multidisciplinary teams to review complex cases. Ensure compliance with regulatory and payer-specific guidelines. Document and maintain accurate and comprehensive review records. Participate in quality improvement and audit initiatives. Qualifications Active PHRN license At least 1 year of clinical nursing experience in utilization review or case management experience preferred. Must have minimum acute bedside experience Proficient in using InterQual and MCG guidelines . Strong working knowledge of NCD and LCD criteria and application. Experience in developing or implementing clinical decision trees or algorithms. Seniority level Entry level Employment type Full-time Job function Health Care Provider Telephone Call Centers #J-18808-Ljbffr
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Utilization Review Nurse | UMR | PHRN | Pasay
2 weeks ago
Pasay, Philippines Access Healthcare Services Manila, Inc. Full timeAccess Healthcare Services Manila, Inc. On-site - Pasay 1-3 Yrs Exp Bachelor Full-time Share Job Description We are seeking a highly skilled and detail-orientedPH Registered Nurse (PHRN) to join our team. The ideal candidate will have hands-on experience withInterQual ,MCG ,NCD , andLCD Guidelines Key Responsibilities Conduct clinical reviews of inpatient...
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Utilization Review Nurse
2 days ago
Pasay, National Capital Region, Philippines Private Advertiser Full time ₱900,000 - ₱1,200,000 per yearWe're looking for skilled Utilization Review Nurses (PHRN-USRN) to join our dynamic team and ensure medical necessity, cost-efficiency, and compliance with health plan policies and regulatory standards. QualificationsMust have active PHRN or USRN licenseMinimum of 2 years of acute care management in a hospital set upMust have 1 year of experience in...
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Utilization Review Nurse
1 week ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱1,200,000 - ₱2,400,000 per yearWe are seeking a highly skilled and detail-oriented PH Registered Nurse (PHRN) to join our team. The ideal candidate will have hands-on experience with InterQual, MCG , NCD, and LCD GuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the...
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Utilization Review Nurse
4 days ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱800,000 - ₱1,200,000 per yearWe are seeking a highly skilled and detail-orientedPH Registered Nurse (PHRN)to join our team.The ideal candidate will have hands-on experience withInterQual,MCG,NCD, andLCDGuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the medical...
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Pasay, National Capital Region, Philippines Access Healthcare Full time ₱420,000 - ₱540,000 per yearJob description:Access Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...
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PHRN Clinical Trainer | UMR experience required
2 weeks ago
Pasay, Philippines Access Healthcare Full timePHRN Clinical Trainer | UMR Experience Required We are seeking a motivated and experienced Clinical Trainer to join our Healthcare Business Processing Outsourcing Team. In this role, you will be responsible for overseeing the clinical training programs, ensuring deployed employees possess the necessary skills and knowledge to deliver exceptional services to...
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PHRN Clinical Trainer
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱60,000 - ₱120,000 per yearThe role Access Healthcare Services Manila, Inc.' is seeking a experienced PHRN Clinical Trainer to join our UMR team based in Pasay City Metro Manila. This is a full-time position and will play a crucial role in delivering high-quality training to our clinical staff.Key responsibilitiesDevelop and deliver comprehensive training programs to ensure clinical...
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Pasay, Philippines Access Healthcare Services Manila, Inc. Full timeAccess Healthcare is looking for REGISTERED NURSE to join our growing team. You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities Perform advanced level work related to clinical denial and utilization management....
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Pasay, Philippines Access Healthcare Full timePHRN Clinical Trainer | UMR | Up to 100k sign on bonus ( for immediate joiners) We are seeking a motivated and experienced Clinical Trainer to join our Healthcare Business Processing Outsourcing Team. In this role, you will oversee the clinical training programs, ensuring that deployed employees possess the necessary skills and knowledge to deliver...
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PH Registered Nurse – Quality Analyst
2 hours ago
Pasay, National Capital Region, Philippines access healthcare Full time ₱900,000 - ₱1,200,000 per yearWe are currently looking for Registered Nurse Quality Analyst to be part of our ClinicalteamThe Quality Analyst will be responsible for monitoring and evaluating the quality ofcustomer service interactions, identifying areas for improvement, and ensuringcompliance with policies and procedures. The successful candidate must be a RegisteredNurse with...
