Remote USRN Team Leader - Utilization Management

Capacita Human Resource Management Consultancy; Manila; On-site; PHP 609,000 - 730,000; Full time

Benefits offered by this job

100% Work-from-Home setup

PHP 60,000 package

Job summary

Capacita Human Resource Management Consultancy is seeking a USRN Team Leader to oversee a remote team delivering Utilization Management in US healthcare accounts. Strong leadership, clinical judgment, and a background in BPO/CPO healthcare settings are required.

The role offers a 100% work-from-home setup with a PHP 60,000 monthly package, open to Metro Manila, Pampanga/Central Luzon, Cebu, and other Philippine locations.

Qualifications

• Active US Registered Nurse (USRN) license – any US state.
• 2–3 years of BPO/CPO healthcare experience.
• 2–3 years of Utilization Management (UM) experience or related clinical review experience.
• Strong understanding of UM processes, clinical documentation, and healthcare review workflows.
• Excellent written and verbal communication; able to work independently in a remote setup.

Responsibilities

• Lead, coach, and support a team of USRN healthcare professionals in day-to-day operations.
• Monitor team performance and ensure productivity, quality, and turnaround-time targets.
• Provide guidance on complex Utilization Management and clinical review cases.
• Review and ensure proper application of clinical guidelines, policies, and procedures.
• Coaching, performance discussions, and development of team members.
• Onboard, mentor, and transfer knowledge to new team members.
• Ensure accurate completion of healthcare documentation and clinical review tasks.
• Escalate complex issues to management when needed.
• Promote compliance with healthcare policies and client requirements.

Skills

Team leadership

Utilization Management

Clinical decision-making

Remote work

Healthcare operations

Education

USRN license

Job description

Capacita Human Resource Management Consultancy is seeking a USRN Team Leader to oversee a remote team delivering Utilization Management in US healthcare accounts. Strong leadership, clinical judgment, and a background in BPO/CPO healthcare settings are required.

The role offers a 100% work-from-home setup with a PHP 60,000 monthly package, open to Metro Manila, Pampanga/Central Luzon, Cebu, and other Philippine locations.