Prior Authorization Nurse - PHRN (QA)

HRTX; Philippines; On-site; PHP 600,000 - 800,000; Full time

Job summary

HRTX is recruiting a Clinical/Prior Authorization - Quality Auditor (PHRN) to join our healthcare BPO team in the Philippines. You must hold an active PHRN license and have 4–7 years of Clinical/Prior Authorization or Utilization Review experience.

Quality Auditor experience is preferred but not required, with strong familiarity with EPIC, MCG, or InterQual guidelines. Onsite position in McKinley, Taguig, offering an opportunity to ensure high-quality patient care through rigorous review and

Qualifications

• Must hold an active PHRN license (not USRN).
• 4–7 years of Clinical/Prior Authorization or Utilization Review experience.
• Quality Auditor experience in healthcare BPO is preferred but not required.
• Strong familiarity with EPIC, MCG, or InterQual guidelines required.

Skills

Clinical expertise

Prior Authorization

Utilization Review

Quality auditing

Regulatory compliance

Education

Active PHRN license

Tools

EPIC

MCG guidelines

InterQual guidelines

Job description

About the job Prior Authorization Nurse - PHRN (QA)

Position: Clinical/Prior Authorization - Quality Auditor

Qualifications:

• Must hold an active PHRN license (not a USRN license holder)
• Must have at least solid 4 to 7 years experience in Clinical/Prior Authorization or Utilization Review
• Relevant experience as a Quality Auditor in Clinical Services within a healthcare BPO environment (preferred only, not required)
• Strong familiarity with EPIC, MCG, or InterQual guidelines required
• Amenable to working onsite in McKinley, Taguig