Utilization Review Nurse (Registered Nurse | Non-Bedside | Hybrid Work Setup)

Lunas Solution Corp.; Dumaguete; Hybrid; PHP 240,000 - 360,000; Full time

Job summary

Lunas Solution Corp. in the Philippines invites you to pivot your nursing career into utilization review. The Utilization Review Nurse reviews patient cases to ensure medical necessity while safeguarding patient safety and controlling costs.

This non-bedside role offers a hybrid work setup. Active PHRN license and 1–2 years hospital experience are preferred. Experience in utilization review or case management is a plus, but not required.

Qualifications

• Active Philippine Registered Nurse (PHRN) license.
• 1–2 years of clinical experience in a hospital setting.
• Experience in utilization review, case management, or managed care is a plus but not required.
• Stable internet connection and conducive home office setup.
• Preferably based in Negros Oriental or nearby provinces.

Responsibilities

• Review patient cases to assess medical necessity and appropriateness of care.
• Balance patient safety with cost-effective care.
• Collaborate with care teams as part of the utilization review process.

Skills

Clinical assessment

Communication skills

Problem solving

Education

Philippine Registered Nurse (PHRN) license

Job description

Looking to take your nursing career beyond bedside care?

Join Lunas Solution as a Utilization Review Nurse and use your clinical expertise to review patient cases and ensure appropriate care. In this role, you’ll help improve healthcare delivery by balancing medical necessity, patient safety, and cost-effective care.

This is a great opportunity for nurses who want a non-bedside role with hybrid work flexibility, and exposure to the growing field of healthcare management and insurance review.

Qualifications

• Active Philippine Registered Nurse (PHRN) license

• Minimum of 1–2 years of clinical experience in a hospital setting preferred

• Experience in utilization review, case management, or managed care is a plus but not required

• Must have a stable internet connection and conducive home office setup

• Preferably based in Negros Oriental or nearby provinces