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Utilization Management USRN Analyst
Go-Get Data Consultancy, Metro Manila, Philippines, Metro Manila, Philippines1 day ago
Job descriptionCreates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation. Creates a detailed case summary in narrative format for each appeal. Submits cases as directed for each applicable geographic region. Presents verbal and written case summaries to client’s Grievance Team and client Medical Directors. Completes assignments within client-designated turnaround times. Screening with CV Reviewer Endorse for CV screening through Workday, along with the HRI toolkit, FCV and CV For reviewing with the client Mid-Senior level Full-time Business Development and Sales Business Consulting and Services
Job Overview
WORK SET UP : Full On-site in Uptown BGC, Taguig
WORK SHIFT : Depends with the client and project but they are looking for someone who can work on a shifting schedule
Attractive signing bonus up to Php 100,000. (Terms and Conditions apply)
Eligibility & Requirements
- Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
- Current and unrestricted US Registered Nurse license required
- 3 months clinical experience (480 hours of working experience as a RN)
- At least one year of Utilization Management experience.
- Work experience as an active RN license and providing direct patient care
- Clinical setting includes inpatient hospital, outpatient hospital or community clinic
- Should be able to start by December 2025
- Ready to work full onsite in Taguig
- Applicants must currently reside in the Philippines and have right to live and work in this country
- Should not be a job hopper who works for less than a year per company
Responsibilities
Recruitment Process
Seniority level
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Management Analyst • , Metro Manila, Philippines, Metro Manila, Philippines
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