Hospital RN | Utilization Management (InterQual)

Nezda Technologies, Inc.; Pasig; Presencial; PHP 300.000 - 520.000; Tempo integral

Resumo da vaga

Nezda Technologies, Inc. is seeking a Philippine Registered Nurse to join our healthcare team in hospital-based care and utilization management reviews.

You will apply your clinical knowledge and leverage InterQual or MCG criteria to promote appropriate, high-quality patient care. The role requires at least one year of hospital experience and one year of utilization management review, with strong attention to detail and excellent communication skills.

Qualificações

• Must be a licensed Philippine Registered Nurse.
• Minimum one year hospital experience.
• Minimum one year of utilization management review experience.
• Experience using InterQual or MCG criteria.
• Strong clinical judgment and attention to detail.
• Effective communication skills.

Responsabilidades

• Review clinical information and assess medical necessity using InterQual or MCG guidelines.
• Apply nursing knowledge and hospital experience to utilization management decisions.
• Collaborate with healthcare providers and internal teams to clarify clinical information and support care coordination.
• Maintain accurate, timely, and confidential clinical documentation.
• Escalate complex cases according to established policies and procedures.

Conhecimentos

Registered Nurse

Utilization management

InterQual/MCG criteria

Clinical assessment

Communication

Formação

Philippine Nursing Licensure

Ferramentas

InterQual criteria

MCG criteria

Descrição da vaga

Nezda Technologies, Inc. is seeking a Philippine Registered Nurse to join our healthcare team in hospital-based care and utilization management reviews.

You will apply your clinical knowledge and leverage InterQual or MCG criteria to promote appropriate, high-quality patient care. The role requires at least one year of hospital experience and one year of utilization management review, with strong attention to detail and excellent communication skills.