Nurse Clinician

2 days ago


Davao City, Davao, Philippines beBeeCare Full time ₱50,000 - ₱68,000
Job Title: Clinical Nurse Case Manager

We are seeking an experienced and highly motivated nurse to fill the role of Clinical Nurse Case Manager. This position involves critical thinking, strong clinical expertise, and excellent communication skills.

Key Responsibilities:
  • Conduct reviews to assess appropriateness of treatment settings and ensure compliance with applicable criteria.
  • Review service requests to verify member eligibility, benefits, and contracts.
  • Collaborate with clinical reviewers and medical directors to ensure high-quality, cost-effective care.

Responsibilities also include conducting UM pre-service, concurrent, retrospective, out-of-network, and appropriateness of treatment setting reviews. The ideal candidate will possess an active USRN license, at least 1 year of clinical experience, and a deep understanding of client-specific criteria sets and medical policy guidelines.



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