
Utilization Review Nurse | UMR | PHRN | Pasay
1 day ago
Overview 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 (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. #J-18808-Ljbffr
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PHRN – Healthcare Account
5 hours ago
Manila, National Capital Region, Philippines Global Group Innovative Services, Inc. Full time ₱40,000 - ₱50,000 per yearPHRN – Healthcare Account (BPO and Hospital Experience)Work Setup: 100% OnsiteWork Location: ManilaStart Date: ASAPOpenings: 7Job OverviewWe are hiring Active Philippine Registered Nurses (PHRN) with both hospital and BPO healthcare voice experience. The successful candidate will provide clinical support and medical review assistance to international...
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Manila, Philippines Gap Solution Recurrent Firm Full timeJob Title: PHRN – Healthcare Account (BPO and Hospital Experience) Work Setup: 100% Onsite Work Location: Manila Start Date: ASAP Openings: 7 Job Overview We are hiring Active Philippine Registered Nurses (PHRN) with both hospital and BPO healthcare voice experience. The successful candidate will provide clinical support and medical review assistance to...
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Registered Nurse Associate | BPO
1 week ago
Southern Manila District, Philippines HRTX Full timeAbout the job Registered Nurse Associate | BPO Position: PHRN AssociateLocation: Pasay (Onsite)Work Schedule: Night ShiftSalary: Up to 40,000 Qualifications: Registered Nurse with active PRC license Minimum of 1 year hospital bedside experience (OR, ER, ICU, PACU, General Wards, Post-Surgery Care, or acute hospital settings) At least 1 year of BPO...
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Manila, Philippines GGAS Services Full timePHRN Licensed Must have 1 to 2 yrs in UMR/Prior auth 50k onsite Can work onsite in Ortigas. can work night shift. can start asap. 45k to 50k salsry with singning Bonus. PHRN Licensed Must have 1 to 2 yrs in UMR/Prior auth 50k onsite Can work onsite in Ortigas. can work night shift. can start asap. 45k to 50k salsry with singning Bonus.
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manila, Philippines GGAS Services Full timePHRN Licensed Must have 1 to 2 yrs in UMR/Prior auth 50k onsite Can work onsite in Ortigas. can work night shift. can start asap. 45k to 50k salsry with singning Bonus. PHRN Licensed Must have 1 to 2 yrs in UMR/Prior auth 50k onsite Can work onsite in Ortigas. can work night shift. can start asap. 45k to 50k salsry with singning Bonus.
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PHRN - Utilization Review
1 week ago
Manila, National Capital Region, Philippines PMConsulting Full time ₱600,000 per yearYou'll be responsible for reviewing medical records and clinical documentation todetermine the medical necessity, appropriateness, and efficiency of healthcare servicesprovided. You'll work closely with physicians, case managers, and insurance providers toensure optimal patient care while supporting cost containment efforts.Job Types: Full-time,...
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Utilization Review Nurse
3 weeks ago
, Metro Manila, Philippines Buscojobs Full timeMakati, National Capital Region - Dempsey Resource Management Inc. Posted 7 days ago Job Description Qualifications: A graduate of Nursing (BSN) Licensed Nurse Must have training, certification, and at least one (1) year experience relevant to the job. Good communication skills. Computer literate with proficiency in MS Office, using MS Word, and MS Excel. ...
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Team Leader
3 weeks ago
Manila, Philippines V-Call Center Link Inc. Full timeKey Responsibilities Supervise, coach, and mentor a team of PHRNs in handling clinical and non-clinical BPO-related tasks (e.g., utilization management, prior authorization, claims review, telehealth support). Monitor daily team performance, productivity, and quality metrics. Conduct regular performance reviews and provide constructive feedback. Assist in...
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Occupational Health Nurse
1 week ago
, Metro Manila, Philippines Buscojobs Full timeOccupational Health Nurse Pasay, Pasay Posted 1 day ago Job Description: To improve safety and address health concerns of SCMC employees and customers Provides medical aid, assessment, and recommendation on the health status of each employees based on medical records, conducted physical examination and laboratory results Requirements: Candidate must possess...
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USRN Licensed Team Leader
2 weeks ago
Manila, Philippines GGAS Services Full timeUSRN Licensed Team Leader (TL) – BPO Healthcare UMR Account Location: Onsite – ortiags Salary: Up to ₱90,000 + ₱100,000 Bonus Job Type: Full-Time, Night Shift Job Summary: We are looking for a highly experienced and motivated USRN Licensed Team Leader (TL) with a strong background in BPO, specifically in Healthcare UMR Accounts. The successful...