Utilization management US RN Sr Analyst

4 days ago

Taguig, National Capital Region, Philippines Kels global ventures Full time ₱480,000 - ₱840,000 per year

JOB TITLE: Utilization Management US RN Sr Analyst

WORK SET UP: Full On-site in Uptown BGC, Taguig

WORK SHIFT: Depends with the client and project but they are looking for someone who can work on a shifting schedule

(Salary is confidential but sharing a range here for sourcing purposes only and never share to your candidates, only give them a hint that once they will be selected, the final salary offer will depends to the client and project they will be assigned)

We're looking for candidates with the following skills and experience for this role. Do you fit the profile? If you do, we'd love to hear from you In adherence to the process of Identity Verification, your resume or CV must include your photo to ensure the accuracy of your application.

Minimum Requirements:

  • Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
  • Holds a current and unrestricted US Registered Nurse license is required
  • 3 months clinical experience (480 hours of working experience as a RN)
  • must have at least one year of Utilization Management experience.
  • Work experience as an active RN license and providing direct patient care
  • Clinical setting includes inpatient hospital, outpatient hospital or community clinic
  • No state license required
  • Should be able to start by December 2025
  • Ready to work full onsite in Taguig
  • Open for those applicants who are currently in Philippines and already have the right to live and work in this country are eligible for this role
  • Should not be a job hopper who only works for less than a year per company

Job Description

  • Grievance & Appeals
  • Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation.
  • Creates a detailed case summary in narrative format for each appeal.
  • Submits cases as directed for each applicable geographic region.
  • Presents verbal and written case summaries to client's Grievance Team and client Medical Directors.
  • Completes assignments within client-designated turnaround times.

Job Type: Full-time

Pay: Php40, Php70,000.00 per month

Application Question(s):

  • Do you hold a current and unrestricted US Registered nurse license
  • Do you have the right to live and work in the Philippines
  • Do you have atleast 3 months clinical experience
  • Are you available to work onsite and start in December

Education:

  • Bachelor's (Required)

Experience:

  • Utilization management : 1 year (Required)

Language:

  • English (Required)
  • Filipino (Required)

  • Utilization Management US RN Sr Analyst

    4 days ago

    Taguig, National Capital Region, Philippines Stark Asia Solutions, Inc Full time ₱720,000 - ₱960,000 per year

    Qualifications:Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing DiplomaHolds current and unrestricted US Registered Nurse license3 months clinical experience (480 hours of working experience as a RN)Work experience as an active RN...

  • US RN Senior Analyst

    4 days ago

    Taguig, National Capital Region, Philippines HS Hiring Solutions Inc Full time ₱900,000 - ₱1,200,000 per year

    JOB DESCRIPTION:Grievance & AppealsCreates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation.Creates a detailed case summary in narrative format for each appeal.Submits cases as directed for each applicable geographic region.Presents verbal and written case...

  • ICU RN Auditor

    6 days ago

    Taguig, National Capital Region, Philippines PEO Consulting Limited Full time ₱70,000 - ₱80,000 per year

    Job title: ICU RN AuditorWork set-up: Hybrid in TaguigWork shift: Mid-shiftSalary: PHP 70,000 PHP 80,000Required FTE: 1Job ID: J QUALIFICATIONS: BS Nursing Graduate Licenses: PH RN or US RN Minimum 5 years experience on Post Payment Claims Auditing or ICU RN Auditor and 5-10 years experience on ICU/CCU nursing experience Exposed to ICU experience such as...

  • Sr Quality Analyst

    1 week ago

    Taguig, National Capital Region, Philippines Tech Mahindra Full time ₱1,200,000 - ₱2,400,000 per year

    We're Hiring: Sr Quality Analyst - Thai or Vietnamese SpeakingWork Where People Matter• At Tech Mahindra Philippines, we're more than just a BPO — we're a Certified Great Place to Work where your growth and well-being come first. With thriving hubs in Cebu and Manila, we're helping people like you build meaningful careers while making a real difference...

  • Business Analyst

    6 days ago

    Taguig, National Capital Region, Philippines weSource Management Consultancy Firm Full time ₱45,000 - ₱90,000 per year

    We are looking for Sr. Business Analyst to work for our client located in BGCThis role is on a Hybrid Setup that follows a Night Shift ScheduleSalary is up to 90K max based on experience and interview resultMinimum requirement of 8 years with background in app development in the banking/financial industryA "Senior Business Analyst" is a professional...

  • Sr Manager Technical Support

    4 days ago

    Taguig, National Capital Region, Philippines Tap Growth ai Full time $60,000 - $120,000 per year

    We're Hiring: Sr Manager Technical Support We are looking for a highly skilled and experienced Sr Manager Technical Support to lead our support team in delivering exceptional service to our clients. The ideal candidate will possess extensive technical knowledge, strong leadership abilities, and a commitment to enhancing customer satisfaction....

  • HRIS Sr. Systems Analyst

    1 week ago

    Taguig, National Capital Region, Philippines Cushman & Wakefield Full time ₱1,200,000 - ₱2,500,000 per year

    Job TitleHRIS Sr. Systems AnalystJob Description SummaryThe HRIS Sr. Systems Analyst owns and executes HR data and system related activities for the global People Data Management. This role ensures the accuracy, integrity, and reliability of employee data to support core HR processes, and reporting. Responsible for maintaining data integrity, supporting...

  • IT Business Analyst

    6 days ago

    Taguig, National Capital Region, Philippines Xurpas, Inc. Full time ₱50,000 - ₱100,000 per year

    Summary:As a Business Analyst (BA), you will be responsible for gathering requirements by analyzing existing code and documentation and compiling them into a System Requirement Specification (SRS). You will work closely with developers and stakeholders to ensure alignment on requirements, design and write Test Suites, perform System Integration Testing...

  • Business Analyst

    6 days ago

    Taguig, National Capital Region, Philippines Xurpas Incorporated Full time ₱600,000 - ₱800,000 per year

    Summary:As a Business Analyst (BA), you will be responsible for gathering requirements by analyzing existing code and documentation and compiling them into a System Requirement Specification (SRS). You will work closely with developers and stakeholders to ensure alignment on requirements, design and write Test Suites, perform System Integration Testing...

  • IT Business Analyst

    1 week ago

    Taguig, National Capital Region, Philippines Xurpas Inc Full time ₱80,000 - ₱120,000 per year

    Summary:As a Business Analyst (BA), you will be responsible for gathering requirements by analyzing existing code and documentation and compiling them into a System Requirement Specification (SRS). You will work closely with developers and stakeholders to ensure alignment on requirements, design and write Test Suites, perform System Integration Testing...