Utilization Management Nurse: Clinical Review Specialist

Accenture PLC

Taguig

On-site

PHP 540,000 - 900,000

Full time

6 days ago

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Benefits offered by this job

Signing bonus up to ₱200,000

Job summary

Accenture Philippines in Taguig is seeking a licensed US Registered Nurse to support utilization management reviews in a non-bedside, clinical-review role. This onsite position involves reviewing records, preparing summaries, and collaborating with medical directors.

Ideal candidates have an active US RN license, 3 months of RN clinical experience, and UM/UR exposure, with strong English communication and computer skills. A signing bonus up to ₱200,000 is available for qualified hires.

Qualifications

Must hold recognized nursing degree or diploma.
Current and unrestricted US RN license.
Minimum 3 months (480 hours) of direct patient care RN experience.
Minimum 3 months UM/UR experience.
Strong written and verbal English communication.
Ability to analyze medical records and prepare clear clinical documentation.
Working knowledge of standard computer applications.

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-need, 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.