PH Registred Nurse

2 days ago

Pasay, National Capital Region, Philippines Access Healthcare Full time ₱240,000 - ₱360,000 per year

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.

Qualifications

  • 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.

Job Type: Full-time

Pay: Php40, Php45,000.00 per month

Benefits:

  • Health insurance
  • Life insurance
  • Opportunities for promotion
  • Paid training
  • Pay raise
  • Promotion to permanent employee
  • Transportation service provided

Experience:

  • Utilization Review Nurse: 1 year (Required)
  • Hospital: 1 year (Required)

Work Location: In person

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