Utilization Management Nurse — Non-Bedside Expert

8003 Accenture Inc Company; Taguig; On-site; PHP 600,000 - 720,000; Full time

Job summary

Accenture in Taguig is seeking an experienced USRN Utilization Management Nurse to support timely, evidence-based healthcare decisions through clinical documentation and case evaluation. This non-bedside role advances expertise in health utilization and medical-necessity reviews.

The position requires a nursing degree, an active USRN license, and UM experience. Daily onsite work, with a focus on quality, confidentiality, and collaboration with clinical teams.

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

Nursing degree

USRN license

Clinical RN experience

Utilization Management

English communication

Medical record analysis

Computer literacy

Education

Nursing degree or diploma

Tools

Microsoft Office

Job description

Accenture in Taguig is seeking an experienced USRN Utilization Management Nurse to support timely, evidence-based healthcare decisions through clinical documentation and case evaluation. This non-bedside role advances expertise in health utilization and medical-necessity reviews.

The position requires a nursing degree, an active USRN license, and UM experience. Daily onsite work, with a focus on quality, confidentiality, and collaboration with clinical teams.