Utilization Review Nurse | UMR | PHRN | Pasay

We'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...

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 GuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the...

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, andLCDGuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the medical...

Job 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...

We 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...

Virtual Nurse Supervisor (PHRN) Hybrid Setup | Nightshift Infinit-O Pasay, National Capital Region, Philippines Responsibilities Performance Management: Supervise, mentor, and coach a team of Virtual Triage Nurse Associates to meet and exceed performance metrics and quality standards. Training and Development: Oversee onboarding and ongoing professional...

e are seeking a detail oriented and experienced Registered Nurse (RN) to join our TEAM as a Virtual Utilization Review Nurse.You'll be responsible for reviewing medical records and clinical documentation to determine the medical necessity, appropriateness, and efficiency of healthcare services provided. You'll work closely with physicians, case managers, and...

PHRN – Team LeaderWe are looking for a Registered Nurse Team Lead to oversee and support a team ofUtilization Review Nurses in providing high-quality medical necessity reviews for our U.S.healthcare clients.This leadership role requires strong clinical knowledge, hands-on UR experience, and theability to guide and motivate a team in a fast-paced, remote...

Overview Registered Nurse Associate (PHRN) | HYBRID at HR TechX Corp. Location: MOA, Pasay Work Arrangement: Onsite training for the first 3 months, then HYBRID. Night shift / shifting schedule. Salary: Up to 35,000–37,000 Start Date: ASAP Qualifications At least 2 years of solid Hospital Bedside experience Must hold an active PRC license Willing to...

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 GuidelinesKey ResponsibilitiesConduct clinical reviews of inpatient and outpatient services using InterQual, MCG, NCD, and LCD criteria.Analyze patient records to determine the...