Utilization Management Nurse - Non-Bedside Case Review

Accenture in the Philippines; Taguig; On-site; PHP 480,000 - 720,000; Full time

Benefits offered by this job

Signing bonus up to ₱200,000

Job summary

Accenture in the Philippines is seeking a USRN Utilization Management Nurse for a non-bedside, utilization-focused role in Taguig. You will review medical records, prepare summaries, and communicate findings to clinical teams, supporting medical-necessity decisions.

This onsite position emphasizes confidentiality, rapid case turnaround, and collaboration with medical directors. A nursing degree and a valid US RN license are required, with at least 3 months UM or utilization review experience.

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.
• 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-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

US RN license

Clinical RN experience (3 months)

Utilization Management experience

English communication

Medical records analysis

Computer literacy

Education

Nursing degree or diploma

Tools

Microsoft Office

Job description

Accenture in the Philippines is seeking a USRN Utilization Management Nurse for a non-bedside, utilization-focused role in Taguig. You will review medical records, prepare summaries, and communicate findings to clinical teams, supporting medical-necessity decisions.

This onsite position emphasizes confidentiality, rapid case turnaround, and collaboration with medical directors. A nursing degree and a valid US RN license are required, with at least 3 months UM or utilization review experience.