Remote USRN – Case Review & Care Coordination

Shearwater Health; Metro Manila; Remote; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Sign-on bonus

Work from home setup

HMO on Day 1 with 2 dependents

Job summary

Shearwater Health in the Philippines is seeking a US Registered Nurse to perform medical necessity reviews for prospective, concurrent, and retrospective cases in accordance with client contracts and company policies. The role emphasizes quality and cost effective care for the injured employee.

The position offers a work-from-home setup for selected accounts, visa sponsorship opportunities, and a competitive compensation package with performance bonuses.

Qualifications

• Must have an active PRC license and a US Nursing License.
• At least 1 year of recent and relevant hospital bedside care experience (may include CPO or bedside with PHRN/USRN license after graduation).
• Relevant clinical experience may include UM Intake/Case Setup/Case Build, Authorization Processing, Referral Management, Clinical Documentation Review, Work Queue & Provider Coordination, Benefit Verification, Concurrent/Retrospective Review Support, Care Management Support, and UR/UM.
• Familiarity with the US Healthcare System and medical records/documentation based on client or jurisdictional requirements.
• Excellent communication, organizational, time management, and interpersonal skills.
• Amenable for temporary work-from-home setup (any PH locations).

Responsibilities

• Perform medical necessity reviews for proposed prospective, concurrent, and retrospective cases.
• Ensure reviews align with client contract rules and company policies to support quality and cost-effective care.
• Coordinate with providers and other stakeholders to gather necessary information.

Skills

Active PRC license

US Nursing License

Hospital bedside care

Communication skills

Time management

Interpersonal skills

Job description

Shearwater Health in the Philippines is seeking a US Registered Nurse to perform medical necessity reviews for prospective, concurrent, and retrospective cases in accordance with client contracts and company policies. The role emphasizes quality and cost effective care for the injured employee.

The position offers a work-from-home setup for selected accounts, visa sponsorship opportunities, and a competitive compensation package with performance bonuses.