Urgent Hiring: PHRN | Quezon City

Concentrix Philippines; Quezon City; On-site; PHP 279,000 - 391,000; Full time

Benefits offered by this job

HMO coverage

Life insurance

Leave conversion

Fully Paid Training

Education/Licensure Assistance

Job summary

Concentrix Philippines is hiring for a Utilization Management PHRN to review, process, and resolve UM cases. The role emphasizes timely, clinically sound UM reviews and adherence to member rights and CMS/commercial health plan obligations.

You will support case documentation and contribute to quality and compliance targets of the payer program while working on-site at Bridgetowne, Quezon City. A nursing background and active license are required.

Qualifications

• Bachelor of Science in Nursing (BSN) is required.
• Active nursing license is required.
• Minimum six months of background in clinical process outsourcing and clinical utilization management (BPO).
• Minimum six months bedside experience.

Responsibilities

• Review, process, and resolve utilization management cases.
• Ensure timely and clinically sound UM reviews.
• Uphold member rights and health plan obligations under regulations.
• Support case documentation.
• Contribute to quality and compliance targets of the payer program.

Skills

Clinical knowledge

Communication

Education

BSN

Nursing License

Job description

About the role

The Utilization Management (UM) PHRN is responsible for the review, processing, and resolution of UM cases. The role ensures timely and clinically sound UM review, upholding member rights and health plan obligations under commercial and CMS regulations. The UM PHRN also supports case documentation and contributes to the quality and compliance targets of the payer program.

Key responsibilities

• Review, processing, and resolution of UM cases
• Ensure timely and clinically sound UM review
• Uphold member rights and health plan obligations under commercial and CMS regulations
• Support case documentation
• Contribute to the quality and compliance targets of the payer program

About you

• College Graduate (BSN)
• Active Nursing License
• At least six (6) months background in clinical process outsourcing and clinical role handling utilization management (BPO)
• At least 6 months bedside experience
• Willing to work onsite at Bridgetowne, Quezon City

Benefits

• HMO coverage, life insurance, leave conversion
• Fully Paid Training in communication, culture, and product expertise
• Education/Licensure Assistance Program with financial support for further studies and certifications
• Exclusive Partner Discounts
• High-Value Referral Bonuses
• Performance Incentives
• Night Shift Differential
• Mental Wellness Programs with professional support and wellness initiatives
• Clear, Accelerated Career Pathways with specialized courses, certifications, and language training