Senior Health Clinical Review & Utilization Analyst

Accenture PLC; Taguig; On-site; PHP 480,000 - 720,000; Full time

Job summary

Accenture in Taguig is seeking a Health Clinical Services Senior Analyst to review medical records, prepare concise clinical summaries, and support care-management processes. This onsite role requires a nursing degree and a current US RN license.

You will collaborate with clinical teams, ensure data privacy, and participate in quality reviews, with rotation and on-site work at Taguig Uptown Bonifacio Tower 3.

Qualifications

• Recognized nursing degree, diploma, or acceptable equivalent.
• Current and unrestricted US Registered Nurse license.
• At least three months or 480 hours of clinical RN experience involving direct patient care.
• Minimum of three (3) months of Utilization Management or Utilization Review experience.
• Strong written and verbal communication skills in English.
• Ability to analyze medical records and prepare clear clinical documentation.
• Working knowledge of standard computer applications.

Responsibilities

• Review medical records and clinical documentation for assigned UM cases.
• Evaluate case information based on established review processes and client guidelines.
• Prepare organized, concise, and accurate clinical summaries.
• Identify missing clinical information and coordinate follow-up as needed.
• Document review findings and case actions accurately.
• Support medical-necessity, care-management, and related clinical-review processes.
• Communicate relevant case information to clinical teams and medical directors.
• Manage assigned cases within required quality and turnaround-time standards.
• Protect confidential healthcare and patient information.
• Participate in quality reviews, process calibration, and continuous-improvement activities.

Skills

English communication

Clinical records analysis

Clinical documentation

Computer skills

Education

Nursing degree/diploma

Tools

ICD-9/ICD-10/CPT codes familiarity

Job description

Accenture in Taguig is seeking a Health Clinical Services Senior Analyst to review medical records, prepare concise clinical summaries, and support care-management processes. This onsite role requires a nursing degree and a current US RN license.

You will collaborate with clinical teams, ensure data privacy, and participate in quality reviews, with rotation and on-site work at Taguig Uptown Bonifacio Tower 3.