UM Nurse: Clinical Case Reviewer

Accenture in the Philippines

Taguig

On-site

PHP 400,000 - 600,000

Full time

3 days ago

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Job summary

Accenture in the Philippines is seeking a USRN Utilization Management Nurse to support timely, evidence-based healthcare decisions. This non-bedside role uses nursing expertise to review cases, prepare summaries, identify gaps, and communicate findings to clinical stakeholders.

Daily onsite commitments in Taguig with rotation and ongoing quality improvement. The ideal candidate holds a US RN license, 3+ months UM/UR experience, and strong English communication.

Qualifications

Licensed US RN with active US license.
Minimum 3 months RN experience with direct patient care.
Minimum 3 months UM/UR experience.
Strong English communication skills.
Proficient in medical records review and documentation.

Responsibilities

Review medical records and clinical documentation for UM cases.
Evaluate case information based on client guidelines.
Prepare concise clinical summaries.
Identify missing information and coordinate follow-up.
Document review findings and actions accurately.
Support medical-necessity and care-management processes.
Communicate case information to clinical teams and directors.
Manage cases within quality and turnaround standards.
Protect patient confidentiality.
Participate in quality reviews and process improvements.

Skills

Nursing degree

USRN license

Utilization Management

English proficiency

Medical records review

Education

Nursing degree or diploma

Tools

MS Office

Job description

Daily onsite commitments in Taguig with rotation and ongoing quality improvement. The ideal candidate holds a US RN license, 3+ months UM/UR experience, and strong English communication.

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