Utilization Management Nurse: Clinical Review Specialist

8003 Accenture Inc Company; Taguig; On-site; PHP 480,000 - 600,000; Full time

Benefits offered by this job

Signing bonus up to ₱200,000

Onsite daily in Taguig

Job summary

Accenture in Taguig seeks an experienced USRN Utilization Management Nurse to review medical records and support timely, evidence-based decisions. This non-bedside role focuses on medical-necessity review, clinical documentation, and healthcare operations, with a signing bonus for eligible hires.

Applicants must have a nursing degree and a valid US RN license, plus UM experience. Daily onsite work in Taguig is required, with opportunities to collaborate with clinical teams and directors.

Qualifications

• Recognized nursing degree, diploma, or acceptable equivalent.
• Current and unrestricted US Registered Nurse license.
• At least three months or 480 hours of clinical RN experience involving direct patient care.
• Minimum of three (3) months of Utilization Management or Utilization Review experience.
• Strong written and verbal communication skills in English.
• Ability to analyze medical records and prepare clear clinical documentation.

Responsibilities

• 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.

Skills

Nursing degree or equivalent

US Registered Nurse license

Clinical RN experience (3 months/480+ 

Education

Nursing degree

Tools

Computer applications

Job description

Accenture in Taguig seeks an experienced USRN Utilization Management Nurse to review medical records and support timely, evidence-based decisions. This non-bedside role focuses on medical-necessity review, clinical documentation, and healthcare operations, with a signing bonus for eligible hires.

Applicants must have a nursing degree and a valid US RN license, plus UM experience. Daily onsite work in Taguig is required, with opportunities to collaborate with clinical teams and directors.