DE033862-USRN Utilization Management Nurse

Accenture PLC; Taguig; On-site; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Signing bonus up to ₱200,000

Job summary

Accenture PLC in Taguig is seeking licensed US RNs for a Utilization Management role in healthcare. This on-site opportunity offers a path within a non-bedside clinical review team and provides a signing bonus for qualified hires.

Join the team to review medical records, evaluate cases per client guidelines, and prepare concise clinical summaries. The position emphasizes patient confidentiality, timely case handling, and collaboration with clinical directors in a fast-paced BPO setting.

Qualifications

• Recognized nursing degree, diploma, or acceptable equivalent.
• Current and unrestricted US Registered Nurse license.
• At least three months or 480 hours of clinical RN experience involving direct patient care.
• Minimum of three (3) months of Utilization Management or Utilization Review experience.
• Strong written and verbal communication skills in English.
• Ability to analyze medical records and prepare clear clinical documentation.
• Working knowledge of standard computer applications.

Responsibilities

• Review medical records and clinical documentation for assigned UM cases.
• Evaluate case information based on established review processes and client guidelines.
• Prepare organized, concise, and accurate clinical summaries.
• Identify missing clinical information and coordinate follow-up as needed.
• Document review findings and case actions accurately.
• Support medical-necessity, care-management, and related clinical-review processes.
• Communicate relevant case information to clinical teams and medical directors.
• Manage assigned cases within required quality and turnaround-time standards.
• Protect confidential healthcare and patient information.
• Participate in quality reviews, process calibration, and continuous-improvement activities.

Skills

English communication

US RN license

Analytical skills

Clinical documentation

Education

RN degree or diploma

Tools

MS Office

EMR systems

Job description

---ONLY THOSE APPLICANTS WHO ALREADY HAVE THE RIGHT TO LIVE AND WORK IN THIS COUNTRY ARE ELIGIBLE TO APPLY FOR THIS ROLE---

RESPONSIBILITIES

Join our healthcare team and apply your clinical expertise in a rewarding non-bedside career. Available to qualified hires. Terms and conditions apply.

• Advance your USRN career with a Signing Bonus of up to ₱200,000.
• Review medical records and clinical documentation for assigned UM cases.
• Evaluate case information based on established review processes and client guidelines.
• Prepare organized, concise, and accurate clinical summaries.
• Identify missing clinical information and coordinate follow-up as needed.
• Document review findings and case actions accurately.
• Support medical-necessity, care-management, and related clinical-review processes.
• Communicate relevant case information to clinical teams and medical directors.
• Manage assigned cases within required quality and turnaround-time standards.
• Protect confidential healthcare and patient information.
• Participate in quality reviews, process calibration, and continuous-improvement activities.

SKILL AND QUALIFICATIONS

• Recognized nursing degree, diploma, or acceptable equivalent.
• Current and unrestricted US Registered Nurse license.
• At least three months or 480 hours of clinical RN experience involving direct patient care.
• Minimum of three (3) months of Utilization Management or Utilization Review experience.
• Strong written and verbal communication skills in English.
• Ability to analyze medical records and prepare clear clinical documentation.
• Working knowledge of standard computer applications.

Preferred Qualifications

• Clinical appeals, claims review, healthcare audit, insurance, or care-management experience.
• Quality assurance, Trainer, Team Lead, or subject-matter expert experience.
• Familiarity with ICD-9, ICD-10, or CPT codes.
• Experience in a healthcare BPO or clinical-process environment.

Work Arrangement

• Daily Onsite setup in Taguig
• Rotational or shifting schedule

#LI-PH

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