Utilization Management Nurse (USRN)

J-K Network Services; Taguig; On-site; PHP 609,336 - 729,864; Full time

Benefits offered by this job

Government-mandated benefits

HMO

13th Month Pay

Sick Leave Credits

Vacation Leave Credits

Job summary

A global IT-BPO company in Taguig is seeking a US Registered Nurse, offering a salary of up to Php60,000 and above. Responsibilities include reviewing clinical cases, conducting utilization reviews, and coordinating with healthcare providers. Candidates must hold an active US RN license, with at least 5-8 years of clinical experience. The role requires onsite work during the night shift, and the company provides numerous benefits including government-mandated benefits and HMO.

Qualifications

• Must have passed the US Nursing Licensure Exam.
• Active and unrestricted US RN license is required.
• Minimum of 5-8 years of clinical experience.

Responsibilities

• Review clinical cases for medical necessity and benefit eligibility.
• Conduct utilization reviews.
• Apply clinical guidelines and escalate cases when necessary.
• Coordinate with healthcare providers and internal teams.
• Ensure accurate documentation and compliance.

Skills

Clinical assessment

Utilization review

Documentation

Coordination

Education

Bachelor’s degree in Nursing

Job description

This company started its operation in 2009. They support the clients globally across North America, Europe, Middle East and Asia. They also offer technology, back office, data engineering, and cloud solutions.

Position: US Registered Nurse (Earn up to Php60,000 and above)

Industry: IT-BPO Company

Location: Taguig City

Salary: Negotiable

Work Schedule: Night Shift

Work Setup: Onsite

Benefits:

• Government-mandated benefits
• HMO
• 13th Month Pay
• Sick Leave Credits
• Vacation Leave Credits

Job Requirements:

• Bachelor’s degree in Nursing or General Nursing
• Passed the US Nursing Licensure Exam
• With active and unrestricted US RN license
• At least 5- 8years of clinical experience
• Can start as soon as possible

Job Responsibilities:

• Review clinical cases for medical necessity and benefit eligibility
• Conduct utilization reviews (pre-service, concurrent, retrospective)
• Apply clinical guidelines and elevate cases when needed
• Coordinate with healthcare providers and internal teams
• Ensure accurate documentation and compliance with policies

Recruitment Process:

LOOK TO MS. JAI

• Initial Interview (Online)
• Final Interview (Online / Face-to-Face)
• Job Offer