USRN Team Lead

Responsibilities Lead and manage a team of USRNs involved in clinical functions such as utilization management, case management, prior authorizations, appeals, or claims review. Track and evaluate team performance against established KPIs and SLAs, ensuring quality, productivity, and timely delivery. Ensure full compliance with HIPAA, client-specific...

Overview This position supervises a team of USRNs to deliver accurate, high-quality clinical support and services for healthcare clients within a BPO setting. The role includes managing team performance, providing training and coaching, and ensuring compliance with HIPAA, client policies, and SLA standards. Responsibilities Overseeing clinical processes such...

Role: USRN Team Lead/QA - Utilization ManagementAbout Visaya KPO:Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first approach.Role Overview:We...

About the role Nezda Technologies, Inc. is seeking a talented registered nurse to join our team as a USRN UMR & PHRN - PRIOR AUTH. This is a full-time, based in Ortigas Pasig City Metro Manila. In this strategic position, you will play a crucial part in our efforts to deliver exceptional healthcare services to our clients.What you'll be doingReviewing and...

Qualifications:Active USRN license in any U.S. stateMinimum 2 years of hospital or bedside experience in an acute care setting (Med/Surg, Ortho, ER)Experience using InterQualStrong analytical and clinical judgment skillsKey Responsibilities:Review and analyze denied inpatient claims and determine reasons for denial following IP DRG coding guidelinesPrepare...

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...

We Are Hiring – Healthcare BPO Roles Location: Manila & Cebu (depending on the role) Work Setup: Onsite / Temporary WFH Start Dates: Varies per role Salary Range: Competitive (up to PHP 100,000 depending on experience)Open Positions1. USRN MCGStart Date: 22-SepWork Setup: Temporary WFHSalary: Up to PHP 95,000Non-Negotiable Qualifications:1 year inpatient...

Overview Visaya Pasig, National Capital Region, Philippines — 1 week ago Be among the first 25 applicants. 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...

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...

Overview Visaya Knowledge Process Outsourcing Corporation is a proudly Filipino organization recognized globally for service excellence, innovation, and a culture of malasakit. We are committed to building long-term partnerships through quality, reliability, and a people-first approach. Role: Utilization Management / Review Nurse We are seeking a skilled...