Remote Utilization Review RN – Philippines Licensed

Private Advertiser; Pasay; Remote; PHP 420,000 - 660,000; Full time

Job summary

Private Advertiser in the Philippines is seeking a detail oriented Registered Nurse (RN) to join as a Utilization Review Nurse, working from home. You will review medical records, assess medical necessity, and ensure compliance with clinical guidelines and standards.

This remote role offers flexibility for nurses exploring non-bedside careers while maintaining clinical expertise and professional growth within a compliant framework.

Qualifications

• Must be a Licensed Registered Nurse (RN) in the Philippines.
• Experience in utilization review, case management, or medical records is an advantage.
• Strong clinical assessment and analytical skills.
• Excellent written and verbal communication skills.
• Detail-oriented, organized, and able to work independently.
• Able to work remotely and manage time effectively.

Responsibilities

• Review medical records and clinical documentation to assess medical necessity and appropriateness of healthcare services.
• Evaluate services against established clinical criteria and policies.
• Analyze clinical information to support utilization management decisions.
• Identify missing or inconsistent documentation and coordinate with providers for additional information.
• Ensure timely completion of utilization review assessments and maintain confidentiality.

Skills

Clinical assessment

Analytical skills

Communication skills

Time management

EMR experience

Education

Bachelor of Science in Nursing

Tools

EMR systems

Job description

Private Advertiser in the Philippines is seeking a detail oriented Registered Nurse (RN) to join as a Utilization Review Nurse, working from home. You will review medical records, assess medical necessity, and ensure compliance with clinical guidelines and standards.

This remote role offers flexibility for nurses exploring non-bedside careers while maintaining clinical expertise and professional growth within a compliant framework.