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Utilization Nurse Reviewer – USRN

unlimited holidays - extra holidays - extra parental leave - long remote period allowed
Remote: 
Full Remote
Contract: 
Experience: 
Junior (1-2 years)
Work from: 

Offer summary

Qualifications:

Active USRN license, 1 year clinical/hospital experience, USRN with RN licensse.

Key responsabilities:

  • Partnership with multiple companies
  • Review service requests for compliance
  • Conduct medical management review activities
  • Consult with team for quality care
Nezda Technologies Inc. logo
Nezda Technologies Inc. Human Resources, Staffing & Recruiting Scaleup https://www.nezdaglobal.com/
201 - 500 Employees
See more Nezda Technologies Inc. offers

Job description

Earn P100,000 Signing Bonus! Nezda is looking for Utilization Nurse Reviewer – USRN.

💰 Salary: P50,000 – P70,000
❗️ Work from Home

Qualifications:
✅ Active and non-active USRN license
✅ With at least 1 Year of clinical or hospital experience
✅ USRN with RN license

Job Description:
👉🏻 We are in partnership with multiple companies for this position, so you have an option and which company fits you best.
👉🏻 Please take note that this is direct employment with no bond.
👉🏻 Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
👉🏻 Responsible for conducting medical management review activities that require the review of clinical information against client-specific criteria as noted above but excludes denial determinations.
👉🏻 Consult with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.

Job Type: Full Time
Job Location: Anywhere in the Philippines

Required profile

Experience

Level of experience: Junior (1-2 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

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