PHRN Back Office Specialist Position Sagility Bridgetowne

PHRN Care Management Associate

A PHRN Back Office Specialist supports healthcare operations by performing administrative and clinical tasks in a non-voice (back office) setting. This role is ideal for licensed Philippine Registered Nurses (PHRNs) looking to apply their medical knowledge in a corporate or BPO environment.


Review and process medical records, charts, and insurance claims
Interpret and analyze clinical data for accuracy and compliance
Update patient information in EMR systems
Perform utilization review and pre-authorization tasks
Coordinate with healthcare providers via email or internal systems
Ensure HIPAA and data privacy compliance
Support US-based nurses or doctors in back-office operations


The PHRN Care Management Associate is responsible for providing clinical support in the review and coordination of patient care services. Working under the direction of Care Managers or Physicians, the associate helps ensure that members receive the right care at the right time. This role is often performed in a healthcare BPO setting, supporting U.S. health insurance clients with utilization management, care coordination, and administrative functions.

Medical Records Review

Analyze clinical documents to determine medical necessity, appropriateness, and level of care required.


Telephonic/Virtual Care Coordination

Assist with outreach to providers or members to gather additional information, provide updates, or clarify care plans.


Utilization Management Support

Conduct initial clinical reviews for pre-authorizations, concurrent reviews, or post-service evaluations based on evidence-based guidelines.


Documentation and Data Entry

Accurately record findings in EMR systems, authorization portals, and internal databases following HIPAA and company policies.


Compliance and Quality Assurance

Ensure all activities adhere to regulatory standards (e.g., NCQA, URAC) and internal audit requirements.


Support for Case Managers and Physicians

Collaborate with nurses, physicians, or other health professionals to assist in executing care management plans.


Report Generation and Administrative Tasks

Assist in compiling utilization data, summaries, and reports to support decision-making and care planning.


BACK OFFICE POSITION
Requirements

BS Nursing with active PHRN Licensed -(Non USRN license)
Good communication skills
Amenable to work onsite
Available ASAP
No ongoing/pending NCLEX application


Experience Required:

1 year hospital experience
Direct Patient Care Experience/hospital
Or as Company / School / Clinic Nurse with COE


Basic Salary:

₱30,000 (excluding benefits)
Allowances

Upon Hire:

₱30,000 basic pay
₱1,000 flex fund allowance
Signing Bonus: ₱30,000
₱20,000 one-time relocation allowance (if willing to relocate)

Other Benefits:

20% night differential
HMO coverage for employee upon Day 1
HMO dependents coverage upon certification
Life and Accident Insurance
Annual increase based on performance
Work From Home (based on performance) once regularized

With: Relocation Package (if willing to relocate)

Eligible for Relocation Allowance:

For Luzon – Residing beyond NCR, Rizal, and Bulacan
Must relocate for business needs

Application Process:

Pure Virtual Process – Pure over-the-phone interview
Can Start ASAP

Please Set Proper Expectations Regarding the Documents/Requirements Needed Before Final Interview:

Picture of PRC ID
Selfie holding the PRC card
Proof of address