US Registered Nurse - Utilization Management (Remote)

Level Up Talent Solutions; Manila, Cebu City, Davao City; Hybrid; PHP 391,000 - 580,000; Full time

Job summary

Level Up Talent Solutions is seeking a Lean-Pro US Registered Nurse with an active mainland U.S. RN license to support a non-voice healthcare operations account from a temporary WFH setup with onsite reporting as needed at Shearwater sites in Cebu, Manila, Pampanga or Davao.

The role reviews healthcare information, applies clinical judgment, follows Utilization Management workflows, and maintains quality, productivity, and compliance.

Qualifications

• Active USRN license
• Experience in Utilization Management, CPO, or bedside care in healthcare (past 3 years)
• Ability to work in a non-voice healthcare account
• Detail-oriented and organized with strong documentation
• Strong written communication and adherence to guidelines

Responsibilities

• Review healthcare-related cases, records or outputs accurately
• Apply clinical judgment when reviewing information
• Follow Utilization Management and CPO workflows
• Maintain quality, productivity, and compliance standards
• Escalate complex cases and process concerns when needed

Skills

Clinical judgment

Documentation skills

Written communication

Attention to detail

Non-voice experience

Job description

Level Up Talent Solutions is seeking a Lean-Pro US Registered Nurse with an active mainland U.S. RN license to support a non-voice healthcare operations account from a temporary WFH setup with onsite reporting as needed at Shearwater sites in Cebu, Manila, Pampanga or Davao.

The role reviews healthcare information, applies clinical judgment, follows Utilization Management workflows, and maintains quality, productivity, and compliance.