Utilization Management Nurse Analyst — Clinical Case Expert

Accenture PLC; Taguig; In loco; PHP 700.000 - 1.100.000; Tempo pieno

Descrizione del lavoro

Accenture is seeking a Health Clinical Services Senior Analyst in Taguig for a return-to-office setup. The role leverages clinical nursing expertise in Utilization Management to review cases, prepare summaries, and coordinate follow-up with clinical teams.

The ideal candidate holds a nursing degree and a current US RN license, with at least three months of RN clinical experience and UM exposure. Strong English communication is required.

Competenze

• Nursing degree or diploma required.
• Current and unrestricted US RN license.
• At least three months of clinical RN experience with direct patient care.
• Minimum three months of Utilization Management or Utilization Review experience.
• Strong written and verbal English.
• Ability to analyze medical records and prepare clear clinical documentation.

Mansioni

• Review medical records and clinical documentation for assigned UM cases.
• Evaluate case information based on established review processes and client guidelines.
• Prepare organized, concise, and accurate clinical summaries.
• Identify missing clinical information and coordinate follow-up as needed.
• Document review findings and case actions accurately.
• Support medical-necessity, care-management, and related clinical-review processes.
• Communicate relevant case information to clinical teams and medical directors.
• Manage assigned cases within required quality and turnaround-time standards.
• Protect confidential healthcare and patient information.
• Participate in quality reviews, process calibration, and continuous-improvement activities.

Conoscenze

Nursing

US RN license

Clinical documentation

Utilization Management

English communication

Formazione

Nursing degree

US Registered Nurse license

Descrizione del lavoro

Accenture is seeking a Health Clinical Services Senior Analyst in Taguig for a return-to-office setup. The role leverages clinical nursing expertise in Utilization Management to review cases, prepare summaries, and coordinate follow-up with clinical teams.

The ideal candidate holds a nursing degree and a current US RN license, with at least three months of RN clinical experience and UM exposure. Strong English communication is required.