PHRN - Utilization Review

PHRN – Healthcare Account (BPO and Hospital Experience)Work Setup: 100% OnsiteWork Location: ManilaStart Date: ASAPOpenings: 7Job OverviewWe are hiring Active Philippine Registered Nurses (PHRN) with both hospital and BPO healthcare voice experience. The successful candidate will provide clinical support and medical review assistance to international...

JOB SUMMARYWe are seeking a skilled Utilization Review Coordinator (URC) to oversee patient insurance certification, compliance with governmental regulations related to hospital stays, and the prevention of denials. Embedded within our utilization review management platform are clinical criteria guidelines, streamlining the review and documentation process....

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...

The Quality Analyst will play a crucial role in ensuring the quality of services provided in our Utilization Management, Clinical Denials, and Appeals accounts. The ideal candidate must be a Licensed Nurse with at least 2 years of relevant experience, responsible for monitoring calls and cases, analyzing performance metrics, and providing feedback to improve...

At 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 onsiteAmenable to complete 2 year bondActive PRC licenseNo pending NCLEX Application or No Active ATTNo Batch 1999's below graduate and take note of the Red flags schoolMust be willing to...

NOW HIRING: NCLEX Review Nurse (Work-from-Home with Onsite Requirements)Future USRN | NCLEX Sponsorship ProgramWork-from-Home Setup (with Onsite Reporting When Required)Night Shift / Shifting Schedules | Weekends OffOverview:Join a top-tier NCLEX Sponsorship Program designed for committed Filipino RNs who are ready to take their nursing career to the next...

ResponsibilitiesWe mainly want the nurse to be reviewing medications for all of our clients. Reaching out to pharmacy if there are low medications. Reviewing medications received by pharmacy. Following up on orders.Takes call at night and all admin tasks.Overnight callouts and questions.Triaging overnight emergencies.Random check-in on cameras.Fall...

We are seeking a detail-oriented and compassionate PHRN Associate to join our healthcare support team. The ideal candidate is a Philippine-licensed Registered Nurse (PHRN) who will provide clinical support for healthcare processes such as utilization management, medical review, claims processing, or telehealth services, depending on the account.This role is...

We are looking for a licensed Philippine Registered Nurse (PHRN) with strong BPO leadership experience to manage operations and lead teams for a Healthcare account. This role combines operational oversight with clinical understanding, ensuring exceptional service delivery, regulatory compliance, and team development in a fast-paced BPO environment.Key...

RESPONSIBILITIES:To provide support to the clinical team and client team to assist in the promotion of quality member outcomes, to optimize member benefits, and to promote effective use of resources. Supports the procedures that ensure adherence to medical policy and member benefits in providing service that is medically appropriate, high quality, and cost...