Utilization Review Nurse
2 weeks ago
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.
- Active PHRN license
- at least 1 year of clinical nursing experience in utilization review or case management experience 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.
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Denials and Appeals Nurse
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱900,000 - ₱1,200,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed. Responsibilities :Perform advanced level work related to clinical denial and utilization...
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Denials and Appeals Nurse
1 week ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱540,000 - ₱660,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...
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PH Registered Nurse Clinical Denial and Appeals
2 weeks ago
Pasay, National Capital Region, Philippines Access Healthcare Full time ₱450,000 - ₱550,000 per yearAccess Healthcare is looking for REGISTERED NURSE to join our growing team.You'll be ensuring the completion of assigned patient cases by doing roll calls, processing concurrent and retro clinical reviews, work processing surgery authorizations, as needed.Responsibilities :Perform advanced level work related to clinical denial and utilization...
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NCLEX Review
2 weeks ago
Pasay, National Capital Region, Philippines Find HR PH Full time ₱324,000 per yearAt least 2 years solid Hospital or Medical Centers Bedside Exp (as Staff Nurse) and can Provide COEActive PRC licenseReview from home set-up but must be willing to report onsiteMust be available for onsite reporting as needed for training and special eventsAmenable to complete 2-year bondNo pending NCLEX Application or No Active ATTNo Batch 1999's below...
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Industrial Nurse
2 weeks ago
Pasay, National Capital Region, Philippines Maxicare Health Care Full time ₱250,000 - ₱500,000 per yearBe at the heart of workplace safety and wellness — ensuring employees receive the care and support they need to thrive.How You'll ContributeProvide first-aid care, basic treatments & vital signs assessmentAssist the Retainer Physician with physical examinationsMaintain accurate health records and work clearance documentationMonitor clinic census and...
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Company Health Nurse
2 weeks ago
Pasay, National Capital Region, Philippines Maxicare Health Services Inc. Full time ₱276,000 - ₱600,000 per yearBe the heartbeat of employee care As a Company Health Nurse, you'll play a vital role in ensuring a healthy, safe, and supportive workplace—providing medical attention, promoting wellness, and making a positive impact every day.WORK LOCATION: Pasay CitySCHEDULE: 24/7 Rotational ShiftingDUTIESProvide immediate care: First-aid, wound dressing, basic...
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US Registered Nurse
1 week ago
Pasay, National Capital Region, Philippines GeBBS Full timeGeBBS Healthcare is looking for USRN License to ensure that our services meet all necessary requirements before they reach the client.Skills and Qualifications:With an active USRN license in any state.At least 2 years Clinical experience and Healthcare BPOHighly organized with excellent attention to detailWilling to train in MOA, Pasay Site then WFH set...
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NCLEX Scholars Wanted – 30,000 Signing Bonus
2 weeks ago
Pasay, National Capital Region, Philippines Eclaro Full time ₱216,000 - ₱324,000 per yearNCLEX Scholars Wanted – ₱30,000 Signing BonusLocation: Work from Home (must be willing to report onsite)We're looking for Registered Nurses who want to join our NCLEX Scholarship Program and take their careers to the next levelQualifications:At least 2 years hospital or medical center experience as a Staff Nurse (with COE)Active PRC licenseNo pending...
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Medical Abstractor
1 week ago
Pasay, National Capital Region, Philippines Private Advertiser Full time ₱900,000 - ₱1,200,000 per yearWe are a growing Healthcare BPO company providing high-quality medical support services to our international clients. With a strong focus on accuracy, compliance, and patient data confidentiality, we are seeking PHRN-certified Medical Abstractors to join our dynamic team.Role Overview:As a Medical Abstractor, you will be responsible for reviewing and...
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High-Performance Computing
2 weeks ago
Pasay, National Capital Region, Philippines New York Global Consultants Inc. (NYGCI) Full time ₱900,000 - ₱1,200,000 per yearRole Overview:The resource will be embedded with the customer's team to resolve immediate performance issues and establish long-term best practices. Key responsibilities include:Tuning the existing Slurm cluster to address configuration issues and performance bottlenecks during large model trainingReviewing storage and performance options to accelerate...