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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, At least 1 year experience, US RN license.

Key responsabilities:

  • Review service requests for compliance.
  • Conduct medical management review activities.
  • Consult with clinical reviewers for 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

Nezda is hiring Utilization Nurse Reviewer – USRN.

💰 Salary: P50,000 to P70,000 + P100,000 Signing Bonus
📌 Work from Home

Qualifications:
✅ Active and Non-Active USRN license
✅ With at least 1 year clinical or hospital experience
✅ USRN with RN license

Job Description:
👉🏻 We are in partnership to multiple companies for this position, so you have an option and which company fits you best.
👉🏻 Please take note that this is a direct employment with no bond.
👉🏻 Review service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
👉🏻 Responsible for conducting medical management review activities which 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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