Utilization Management USRN - Non-Bedside Expert

Accenture in the Philippines; Taguig; On-site; PHP 480,000 - 840,000; Full time

Benefits offered by this job

Signing bonus

Onsite in Taguig

Job summary

Accenture in the Philippines is hiring a USRN Utilization Management Nurse to support timely, evidence-based healthcare decisions in a non-bedside role in Taguig.

You will review medical records, prepare clinical summaries, and coordinate with clinical teams while maintaining patient confidentiality and adhering to client guidelines. A nursing degree and US license are required, with UM experience preferred; the role is onsite with opportunities for professional growth.

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.
• 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

English communication

Analytical skills

Computer literacy

Education

Nursing degree

Tools

ICD-9/ICD-10/CPT codes

Job description

Accenture in the Philippines is hiring a USRN Utilization Management Nurse to support timely, evidence-based healthcare decisions in a non-bedside role in Taguig.

You will review medical records, prepare clinical summaries, and coordinate with clinical teams while maintaining patient confidentiality and adhering to client guidelines. A nursing degree and US license are required, with UM experience preferred; the role is onsite with opportunities for professional growth.