Registered Nurse (US RN)

Bravissimo Resourcing Inc.; Taguig; On-site; PHP 360,000 - 540,000; Full time

Benefits offered by this job

Signing bonus of 150K

₱1,000 E-gift voucher

Job summary

A healthcare staffing agency in Metro Manila seeks a Grievance & Appeals specialist to manage appeal records and present case summaries to clients. Candidates must hold a US RN license and have at least three months of clinical experience. This role includes a signing bonus and an E-gift voucher upon application completion. The ideal candidate will demonstrate strong communication skills and a detail-oriented approach. This is an exciting opportunity to contribute to patient care within a dynamic environment.

Qualifications

• Holds current and unrestricted US Registered Nurse license.
• 3 months clinical experience as a registered nurse (RN).
• Experience in inpatient or outpatient clinical settings.
• Active RN license with direct patient care experience
• Clinical settings include inpatient, outpatient, or community clinic
• No state license required
• For CL 10 role USRN + UM, minimum 6 months UM experience
• Experience as TL, QA, Trainer or Claims is a plus

Responsibilities

• Creates complete appeal records for external reviews.
• Submits cases for external appeal reviews.
• Presents case summaries to clients' grievance teams.
• Present verbal and written case summaries to Grievance Team and Medical Directors
• Complete assignments within client turnaround times

Skills

Verbal and written communication

Detail-oriented case summary creation

Clinical experience

Education

Bachelor of Science Nursing (BSN)

General Nursing & Midwifery Diploma

Associate Nursing Degree

Nursing Diploma

Nursing Diploma

Job description

Grievance & Appeals

With SIGNING BONUS 150K and ₱1,000 E-gift Voucher (upon completion of application today)

• Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation.
• Creates a detailed case summary in narrative format for each appeal.
• Submits cases as directed for each applicable geographic region.
• Present verbal and written case summaries spoken to client’s Grievance Team and client Medical Directors.
• Completes assignments within client-designated turnaround times.

Qualifications

• Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
• Holds current and unrestricted US Registered Nurse license
• 3 months clinical experience (480 hours of working experience as a RN)
• Work experience as an active RN license and providing direct patient care
• Clinical setting includes inpatient hospital, outpatient hospital or community clinic
• No state license required
• For CL 10 role USRN + UM, minimum 6 months of UM experience.
• Work experience such as TL, QA, Trainer and Claims are preferred and good to have skills only