Prior Authorization Nurse

23 hours ago


Taguig, Philippines HRTX Full time

About the job Prior Authorization Nurse - PHRN (QA)

Position: Clinical/Prior Authorization - Quality Auditor

Qualifications:

  • Must hold an active PHRN license (not a USRN license holder)
  • Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review
  • Relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment (preferred only, not required)
  • Strong familiarity with EPIC , MCG , or InterQual guidelines required
  • Amenable to working onsite in McKinley, Taguig
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