Utilization Management USRN Analyst

2 days ago

Manila, National Capital Region, Philippines Go-Get Data Consultancy Full time ₱500,000 - ₱1,000,000 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

There is an attractive signing bonus of up to Php 100,000. (Terms and Conditions apply)

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

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.

RECRUITMENT PROCESS:


• Screening with CV Reviewer


• Endorse for CV screening through Workday, along with the HRI toolkit, FCV and CV


• For reviewing with the client

  • usrn

    2 days ago

    Manila, National Capital Region, Philippines Rural Healthcare Solutions Full time ₱900,000 - ₱1,200,000 per year

    Company DescriptionWe suggest you enter details here.Role DescriptionThis is a full-time remote role for a USRN. The USRN will be responsible for providing remote clinical services to patients, including triage, patient education, and coordination of care. The role involves using telehealth technology to evaluate and assess patient conditions, manage...

  • Mass Hiring USRNs

    2 weeks ago

    Manila, National Capital Region, Philippines Global Group Innovative Services, Inc. Full time ₱80,000 - ₱100,000 per year

    US Registered Nurses (USRN) Location: Onsite, Manila Start Date: ASAP Salary: Up to PHP 100,000 (depending on experience) Openings: 10 slots availableQualifications:Active USRN license (in any state)At least 2 years of hospital or bedside experience in an acute care setting (e.g., Med/Surg, Ortho, ER)Experience with InterQual preferredBackground in Inpatient...

  • USRN NCLEX Academy Sponsorship Program

    2 weeks ago

    Manila, National Capital Region, Philippines Shearwater Health Full time ₱1,500,000 - ₱3,000,000 per year

    Let your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersPhysical Sites: Taguig, Pampanga, and CebuOur Clinicians & Associates advocates for better patient care while enjoying these benefits:Temporary Work from Home during review period*All expense-paid NCLEX Scholarship*Guaranteed USRN account...

  • USRN NCLEX Academy Sponsorship Program

    2 days ago

    Manila, National Capital Region, Philippines Shearwater Health Full time ₱30,000 - ₱60,000 per year

    Let your Passion Lead You at the Home of Clinicians with over 5000+ employees who have trusted us with their careersPhysical Sites: Taguig, Pampanga, and CebuOur Clinicians & Associates advocates for better patient care while enjoying these benefits:Temporary Work from Home during review period*All expense-paid NCLEX Scholarship*Guaranteed USRN account...

  • PHRN/USRN | Healthcare BPO

    2 weeks ago

    Manila, National Capital Region, Philippines PMConsulting Full time ₱480,000 - ₱720,000 per year

    We are seeking a highly skilled and dedicated Philippine Registered Nurse (PHRN) with a strong background in Emergency Department (ED) or Intensive Care Unit (ICU) settings. The ideal candidate will provide exceptional patient care, apply critical thinking in high-pressure situations, and support clinical documentation or healthcare-related operations in...

  • PHRN/USRN/NCLEX (Associates, Assistant Manager, & Trainer) | Hybrid Set-up

    2 weeks ago

    Manila, National Capital Region, Philippines Find HR PH Full time ₱900,000 - ₱1,200,000 per year

    About the role Join the dynamic team at Find HR PH as a PHRN/USRN/NCLEX (Associates, Assistant Manager, & Trainer) for Pasay and Cebu. This is a full-time, hybrid role offering a flexible work arrangement between the office and remote locations. As a key member of our Call Centre & Customer Service team, you will play a vital part in supporting our clients...

  • USRN Compact License_WFH

    2 days ago

    Manila, National Capital Region, Philippines HRTX Full time ₱70,000 - ₱150,000 per year

    Job DescriptionThe CDI Specialist uses clinical and coding knowledge for conducting clinically based concurrent and retrospective reviews of inpatient medical records to evaluate the documentation of clinical services by identifying opportunities for improving the quality of medical record documentation, including focused reviews in areas identified by CDI...

  • Electrical Utility Manager

    2 days ago

    Manila, National Capital Region, Philippines Amentum Full time ₱100,000 - ₱300,000 per year

    This is a pre-award opportunity located on Diego Garcia in the Indian Ocean.Provide a qualified Electrical Utility Manager who shall be responsible for managing personnel, budget, and construction and maintenance projects associated with Diego Garcia's Electrical Utility System.Management Skills: a) Must be able to conduct on-site technical risk assessments...

  • Usrn

    2 days ago

    Manila, National Capital Region, Philippines Siegen HR Solutions Full time ₱600,000 - ₱1,200,000 per year

    Responsibilities:Responsible in collaborating with healthcare providers and members to promote quality member outcomes, to optimize members' benefits, and to promote effective use of resourcesEnsures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical...

  • Utility Meter Reader

    1 week ago

    Manila, National Capital Region, Philippines Electrovers Corporation Full time ₱150,000 - ₱250,000 per year

    About the CompanyAt Electrovers Corporation, we strive to provide reliable, timely, and cost-effective utility meter reading services. Our team of experienced, knowledgeable, and courteous meter readers, data station analysts, and field auditors is dedicated to meeting the needs of our clients and their respective customers. We take pride in delivering...