PHRN Utilization Management Nurse (UM Nurse) | Clinical Appeals & Review

Cognizant Softvision; Taguig; On-site; PHP 360,000 - 480,000; Full time

Job summary

Cognizant Softvision, LLC in the Philippines is seeking a licensed Philippine Registered Nurse to contribute to Utilization Management and related healthcare operations, with at least 1 year of UM/UR/clinical appeals or medical coding experience.

The role values bedside nursing experience and ability to review medical records; background in healthcare back-office or BPO is a plus; we value strong analytical, documentation, and communication skills.

Qualifications

• PHRN license required.
• Minimum 1 year experience in UM/UR/clinical appeals, medical coding, or healthcare operations.
• Minimum 1 year bedside nursing or clinical experience.
• Experience reviewing medical records or healthcare documentation is advantageous.
• Background in healthcare back-office or healthcare BPO operations preferred.
• Strong analytical, documentation, and communication skills.

Skills

Analytical skills

Documentation skills

Communication skills

Utilization Management experience

Bedside nursing experience

Medical records review

Education

Philippine Registered Nurse (PHRN) License

Job description

Qualifications

Active Philippine Registered Nurse (PHRN) License

At least 1 year of experience in Utilization Management (UM), Utilization Review (UR), Clinical Appeals, Medical Coding, or Healthcare Operations

Minimum 1-year bedside nursing or clinical experience

Experience reviewing medical records, healthcare documentation, or clinical cases is an advantage

Background in healthcare back-office, clinical review, non-voice, or healthcare BPO operations preferred

Strong analytical, documentation, and communication skills

Why Join Us

At Cognizant, we don't just offer jobs—we build careers that thrive in the digital era.

• Growth That Matters Clear career paths, continuous learning, and opportunities to move into leadership or specialized roles. You're not just filling a seat you're building a future.
• Support That Empowers A collaborative culture where your voice is heard, your ideas matter, and your well-being is prioritized through strong benefits and work-life balance.
• Impact That Inspires A Work on global accounts that shape industries, influence millions of users, and give you a sense of purpose beyond the paycheck.

Your future starts here grow, thrive, and make an impact with Cognizant.