Utilization Review Nurse - Taguig, National Capital Region

Para lamang sa mga rehistradong miyembro Taguig, National Capital Region, Pilipinas

2 linggo ang nakalipas

Default job background

Job Summary

We are hiring US Registered Nurses (USRN) with Utilization Management (UM) experience to join our growing healthcare operations team in BGC. If you are looking to move into a non-bedside corporate healthcare role while still using your clinical expertise this is for you.

Responsibilities

  • Review clinical documentation for medical necessity and coverage
  • Perform concurrent retrospective and/or prior authorization reviews
  • Apply evidence-based guidelines e.g InterQual MCG
  • Communicate with providers and internal care teams
  • Earnsure quality compliance and cost-effective care delivery
      Lorem ipsum dolor sit amet
      , consectetur adipiscing elit. Nullam tempor vestibulum ex, eget consequat quam pellentesque vel. Etiam congue sed elit nec elementum. Morbi diam metus, rutrum id eleifend ac, porta in lectus. Sed scelerisque a augue et ornare.

      Donec lacinia nisi nec odio ultricies imperdiet.
      Morbi a dolor dignissim, tristique enim et, semper lacus. Morbi laoreet sollicitudin justo eget eleifend. Donec felis augue, accumsan in dapibus a, mattis sed ligula.

      Vestibulum at aliquet erat. Curabitur rhoncus urna vitae quam suscipit
      , at pulvinar turpis lacinia. Mauris magna sem, dignissim finibus fermentum ac, placerat at ex. Pellentesque aliquet, lorem pulvinar mollis ornare, orci turpis fermentum urna, non ullamcorper ligula enim a ante. Duis dolor est, consectetur ut sapien lacinia, tempor condimentum purus.
      Kumuha ng buong access

      I-access ang lahat ng mataas na antas na posisyon at makuha ang trabahong pinapangarap mo.

Mga katulad na trabaho

  • Clinical Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig, National Capital Region

    As a , you will review denied claims and evaluate denial reasons in a timely and accurate manner. · ...

  • Utilization Review Nurse

    3 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig

    We are hiring US Registered Nurses (USRN) with Utilization Management (UM) experience to join our growing healthcare operations team. · Active USRN license · At least 6 months Utilization Management experience · ...

  • Medical Review Nurse

    3 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig Buong oras

    · The Medical Review Nurse reviews medical reports for TRICARE beneficiaries. · ...

  • Utilization Review Nurse

    2 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig

    We are looking for a Medical Benefits Review Nurse who will review healthcare service requests and determine coverage eligibility based on clinical criteria and U.S. Federal Employee Health Benefit (FEHB) Program policies. · ,,Active Philippines Registered Nurse license (valid fo ...

  • Utilization Review Nurse

    2 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig Buong oras

    · Utilization Review Nurse (USRN Only - Dayshift) · About the Role · We are looking for a Medical Benefits Review Nurse who will review healthcare service requests and determine coverage eligibility based on clinical criteria and U.S. Federal Employee Health Benefit (FEHB) Progr ...

  • Medical Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig

    The Medical Review Nurse will be responsible for reviewing and processing incoming medical reports for beneficiaries.They will ascertain whether a case can be closed if care is complete or will issue an authorisation to a network provider when follow up care is required. · ...

  • Utilization Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig Buong oras

    The Utilization Management Review Nurse reviews the medical necessity and appropriateness of healthcare services and treatments through the medical information of individual patients and the limited insurance coverage available to them. · ...

  • Utilization Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig

    The Utilization Management Review Nurse reviews the medical necessity and appropriateness of healthcare services and treatments through the medical information of individual patients and the limited insurance coverage available to them. · ...

  • Medical Review Nurse

    2 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig

    The Medical Review Nurse is responsible for reviewing medical reports for TRICARE beneficiaries. · ...

  • Utilization Review Nurse Specialist

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig, National Capital Region

    We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, · Collaborate with physicians and other healthcare professionals to ensure accurate documentation is provided to payors · Ensure strict compliance with payer requirements and reg ...

  • Utilization Review Nurse Specialist

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig

    As a Utilization Review Nurse Specialist at MicroSourcing, you will conduct thorough initial, concurrent, and retrospective reviews of patient medical records to determine the medical necessity and appropriate level of care. · At least 1 year of utilization review experience · Cl ...

  • USRN Utilization Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig, Metro Manila

    We are looking for a Utilization Review Nurse who will perform medical necessity review of proposed prospective concurrent and retrospective cases such as medical treatments auto-injury related request hospitalization home care and inpatient/outpatient treatment plans for medical ...

  • Utilization Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Makati, Metro Manila

    Ista Solutions busca un enfermero con experiencia en gestión de reclamos saludables basados en EE.UU. · Realiza revisiones de utilización (UM) según regulaciones estatales/federales y otras disposiciones mandatorias manteniendo cumplimiento con cambios regulatorios afectando UM. ...

  • Medical Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig, National Capital Region

    The Medical Review Nurse will review and process incoming medical reports for beneficiaries. · ...

  • Utilization Review Nurse

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasay, National Capital Region

    We are seeking a highly skilled and detail-oriented PH Registered Nurse (PHRN) to join our team. · ...

  • Utilization Review Nurse

    3 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasay, Metro Manila

    We are looking for experienced Utilization Review Nurse to join our team. · Conducting comprehensive reviews of patient medical records to assess the medical necessity and appropriateness of the level of care and treatment provided · Collaborating with healthcare providers to ide ...

  • Utilization Review Nurse Team Leader

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig, Metro Manila

    We are seeking an experienced Utilization Review Nurse Team Leader to lead our team of Utilization Review Nurses in Taguig City, Metro Manila. · Oversee daily activities of the Utilization Review Nurse team · Provide guidance and support to team members · ...

  • Utilization Review Nurse USRN

    1 araw ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig

    The Manila-based Utilization Review Nurse USRN is responsible for reviewing the appropriateness of health care services requested and their coverage under the health insurance policies of participating Program Carriers providing health insurance. · The nurse will conduct care man ...

  • PHRN | Utilization Review Nurse Team Leader

    1 buwan ang nakalipas

    Para lamang sa mga rehistradong miyembro Taguig, Metro Manila

    The opportunity: Access Healthcare Services Manila, Inc. is seeking a highly motivated and experienced PHRN | Utilization Review Nurse Team Leader to join our dynamic team. · Provide leadership and oversight to the Utilization Review Nursing team, ensuring efficient and effective ...

  • PHRN Medical Review Nurse – UMR

    2 linggo ang nakalipas

    Para lamang sa mga rehistradong miyembro Pasig Remote na trabaho

    The PHRN Medical Review Nurse will review medical records for medical necessity and level of service. · ...

    • Tingnan pa