Utilization Management Lead – Night Shift (Onsite)

MicroSourcing; Taguig; On-site; PHP 1,339,000 - 2,009,000; Full time

Benefits offered by this job

Healthcare coverage day 1

Performance bonuses

Paid time off

Job summary

MicroSourcing is seeking an Utilization Management Supervisor to lead a team of UR and denials specialists at our BGC, Taguig City site. This onsite night-shift role requires a BSN with active PHRN/USRN, 1 year supervisory experience, and 3–5 years of acute care clinical background.

You will monitor SLAs, ensure payer guideline compliance, and drive process improvements across utilization management and revenue cycle. Strong leadership and US healthcare knowledge are essential.

Qualifications

• Bachelor of Science in Nursing with an active PHRN or USRN license.
• 1 year supervisory experience in Utilization Management/Clinical Denials & Appeals.
• 3–5 years acute care clinical experience (Med/Surg preferred; ICU if applicable).
• Proficiency with InterQual or MCG guidelines and US regulations.
• Experience with hospital EMRs (Epic, Cerner, Meditech).
• Strong English communication (CEFR B2).
• Leadership, coaching, and analytical skills.

Responsibilities

• Lead and supervise a team of Utilization Review and Denials & Appeals specialists.
• Monitor productivity, quality, SLAs, and implement performance improvement actions.
• Oversee utilization reviews, denials, and appeals per client/payer guidelines.
• Conduct audits to ensure regulatory and documentation compliance.
• Develop operational reports, dashboards, and KPIs for leadership.
• Collaborate with IT and cross-functional teams to optimize systems.

Skills

Supervisory experience

InterQual/MCG guidelines

EMR software

English communication

Leadership

Education

BSN with active PHRN/USRN license

Tools

Epic

Cerner

Meditech

Job description

MicroSourcing is seeking an Utilization Management Supervisor to lead a team of UR and denials specialists at our BGC, Taguig City site. This onsite night-shift role requires a BSN with active PHRN/USRN, 1 year supervisory experience, and 3–5 years of acute care clinical background.

You will monitor SLAs, ensure payer guideline compliance, and drive process improvements across utilization management and revenue cycle. Strong leadership and US healthcare knowledge are essential.