USRN – Health Clinical Services Senior Manager

1 week ago


Taguig, National Capital Region, Philippines PROTALENTNEXUS CONSULTING Full time

USRN – Health Clinical Services Senior Manager

Location: Taguig City (Onsite, Uptown Bonifacio Tower 3)

Shift: Night Shift | Weekends Off

Hiring Level: Senior Leadership

Salary Range:

About the Role

We are hiring an experienced US Registered Nurse (USRN) to lead clinical review and utilization management teams within a healthcare services environment. This is a senior leadership role responsible for overseeing medical necessity reviews, claims analysis, and clinical compliance activities while ensuring service excellence and regulatory adherence.

This position is ideal for seasoned clinical leaders with strong utilization review, people management, and healthcare operations experience.

Key Responsibilities

Lead and oversee clinical teams performing:

Pre service, concurrent, retrospective, and out of network reviews

Medical necessity and appropriateness of care evaluations

Post service claims and contractual reviews

Ensure compliance with medical policies, member benefits, and health plan guidelines

Manage inbound and outbound clinical communications with providers

Review pended claims for medical necessity and contractual accuracy

Drive quality, productivity, and compliance across teams

Provide leadership, coaching, and performance management to supervisory staff

Qualifications

Active and unrestricted USRN license (any state)

At least 12 years of relevant experience, including 10 years in a supervisory/leadership role

Experience in Utilization Review, Clinical Review, or Health Services Management

Work Setup

Onsite role based in Taguig City

Night shift schedule

Weekend rest days



  • Taguig, National Capital Region, Philippines Cruz-Caymo Partners and Associates, CPAs Full time

    JOB TITLE: Health Clinical Services Senior Manager - USRNWORK SET UP: Onsite in TaguigWORK SHIFT: Night shiftRest Day: WeekendsLocation: Taguig CitySalary budget: 150K - 250KResponsibilities:Oversees staff whose teams' primary duties may include, but are not limited to:Conducts pre-service, concurrent, retrospective, out of network and appropriateness of...

  • Usrn

    7 days ago


    Taguig, National Capital Region, Philippines HRTX Full time

    USRN - Emergency Department / Medical Surgical Ward/ ICU | 100K SOBWe accept any state of USRN license now WE'RE HIRING: USRN - CDI Specialist Location: BGC, Taguig Work Arrangement: Mid Shift | Onsite Company: PM ConsultingAre you a US Registered Nurse looking to shift into a documentation-focused role while utilizing your clinical expertise? PM Consulting...

  • USRN- Nurse Trainer

    7 days ago


    Taguig, National Capital Region, Philippines Tata Consultancy Services Full time

    Job Summary: We are seeking a dynamic and experiencedClinical Nurse Trainer (USRN)to lead onboarding, skills development, and ongoing training for registered nurses supporting telephonic triage, utilization management, prior authorization, and administrative clinical support functions. The ideal candidate will combine clinical knowledge, adult learning...

  • usrn

    2 weeks ago


    Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time

    About the job: USRN (Taguig) | Onsite Work Setup: 100% Onsite Location: Taguig TARGET SD: FEB 5, 2026 REQUIREMENTS:College Graduate of BS NursingActive PHRN & USRNBachelor of Science in Nursing with active US license in at least one US stateAt least 1-3 years of acute, hospital-based clinical experience in a medical/surgical unit, emergency department,...

  • usrn

    2 weeks ago


    Taguig, National Capital Region, Philippines RSD Human Resource Management Consultancy Full time

    At least 2 years clinical experienceActive USRN License is requiredJob Type: Full-timePay: Php52, Php54,000.00 per monthBenefits:Flexible scheduleFlextimePaid trainingExperience:Coding: 2 years (Required)clinical: 2 years (Required)paying or denying bills: 1 year (Required)License/Certification:Medical Coder License (Required)USRN or PHRN License...


  • Taguig, National Capital Region, Philippines Nityo Infotech Full time

    USRN QA SpecialistWith at least 1-2 years of Utilization Management experience ; must have no Priority DateLicense: USRNHighly prefer - no ongoing US applicationAt least 6 months of related clinical work experienceThe Quality Assurance (QA) Specialist is responsible in ensuring accuracy of information and quality of delivery by monitoring, auditing,...


  • Taguig, National Capital Region, Philippines TASQ Staffing Solutions Full time

    About the job: USRN (Taguig) | OnsiteWork Setup: 100% OnsiteLocation: TaguigTARGET SD: FEB 5, 2026REQUIREMENTS:College Graduate of BS NursingActive PHRN & USRNBachelor of Science in Nursing with active US license in at least one US stateAt least 1-3 years of acute, hospital-based clinical experience in a medical/surgical unit, emergency department, and/or...

  • USRN | Nonvoice

    1 week ago


    Taguig, National Capital Region, Philippines Stark Asia Solutions, Inc Full time

    USRN | Temp WFH | Nonvoice (10% Voice)Salary: 55k Package + 100k SOBStart Date: Jan. 16, 2026Qualifications:Active PHRN LicenseActive USRN Mainland LicenseAt least 6 Months Bedside/Clinical ExpMust have 1 Year Utilization Management ExperienceNewly Licensed USRN are acceptable provided that you have extensive OJT ExposureMust be amenable to Night Shifts and...


  • Taguig, National Capital Region, Philippines HRTX Full time

    Were Hiring: USRN Clinical Documentation Improvement (CDI) Specialist Location: BGC, Taguig Work Schedule: Mid Shift (Onsite) Start Date: ASAPAre you a USRN with a strong clinical background looking to transition into a dynamic documentation-focused role? Join our team as a Clinical Documentation Improvement (CDI) Specialist and help bridge the gap between...


  • Taguig, National Capital Region, Philippines HRTX Full time

    This role is responsible for improving the quality, accuracy, and completeness of clinical documentation in the medical record. This role collaborates with physicians, coders, and other healthcare team members to ensure documentation reflects the true clinical picture, supports appropriate code assignment, and meets regulatory and quality reporting...