Utilization Management RN — Non-Bedside Clinical Review (Signing Bonus)

8003 Accenture Inc Company; Taguig; On-site; PHP 446,000 - 781,000; Full time

Job summary

Accenture is recruiting a USRN Utilization Management Nurse in Taguig, Philippines. This non-bedside position leverages your nursing expertise to review medical records, prepare concise clinical summaries, and support evidence-based decisions for managed care clients.

You will evaluate case information against guidelines, identify documentation gaps, coordinate follow-ups, and communicate findings to clinical teams and medical directors. Onsite only.

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 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

US RN license

Clinical RN experience

Utilization Management experience

English communication

Medical records analysis

Computer skills

Education

Nursing degree or diploma

Tools

Computer applications

Job description

Accenture is recruiting a USRN Utilization Management Nurse in Taguig, Philippines. This non-bedside position leverages your nursing expertise to review medical records, prepare concise clinical summaries, and support evidence-based decisions for managed care clients.

You will evaluate case information against guidelines, identify documentation gaps, coordinate follow-ups, and communicate findings to clinical teams and medical directors. Onsite only.