Utilization & Denials Supervisor — Night Shift

MicroSourcing; Philippines; On-site; PHP 900,000 - 1,300,000; Full time

Benefits offered by this job

Healthcare coverage Day 1

Paid time off with cash conversion

Group life insurance

Performance bonuses

Job summary

MicroSourcing is seeking a Utilization & Denials Management Supervisor in Taguig City ( onsite | Night Shift ) to lead a UR/Denials team, manage hiring, onboarding, coaching, and performance. You will monitor SLAs, ensure compliant denials processing, and partner with multiple teams to optimize EMR and related systems.

The role requires a BSN with active PHRN/USRN license, 1 year supervisory experience, 3–5 years acute care experience, and proficiency with InterQual/MCG guidelines and EMR

Qualifications

• Bachelor of Science in Nursing with an active PHRN or USRN license.
• 1 year of supervisory experience in Utilization Management and/or Clinical Denials & Appeals.
• 3–5 years of acute care clinical experience (Med/Surg or similar; ICU 2–3 years).

Responsibilities

• Lead and supervise a team of Utilization Review and Clinical Denials & Appeals specialists, including hiring, onboarding, scheduling, coaching, and performance management.
• Monitor team productivity, quality, turnaround time, and SLAs; implement action plans to address gaps and prevent backlogs.
• Oversee timely review/resolution of utilization management, denials, and appeals per client/payer guidelines.
• Conduct audits and quality reviews to ensure compliance with payer regs and documentation requirements.
• Analyze denial trends and coordinate with Billing, Revenue Cycle, Coding, HIM, and related teams for improvements.
• Develop and present operational reports, KPI dashboards, and leadership updates.
• Collaborate with IT and cross-functional teams to optimize EMR and denials management systems.
• Mentor team members on utilization management and regulatory updates.

Skills

Leadership

Coaching

Analytical

Decision-making

English communication

Education

Bachelor of Science in Nursing

Master's degree (preferred)

Tools

Epic

Cerner

Meditech

InterQual/MCG

MS Office

Job description

MicroSourcing is seeking a Utilization & Denials Management Supervisor in Taguig City ( onsite | Night Shift ) to lead a UR/Denials team, manage hiring, onboarding, coaching, and performance. You will monitor SLAs, ensure compliant denials processing, and partner with multiple teams to optimize EMR and related systems.

The role requires a BSN with active PHRN/USRN license, 1 year supervisory experience, 3–5 years acute care experience, and proficiency with InterQual/MCG guidelines and EMR