Usrn Utilization Management Nurses Temporary Work From Home  

• Performs Utilization Management (UM) reviews in accordance with U.S. State/Federal and other mandated regulations.
• Maintains compliance with regulatory changes affecting UM.
• Reviews UM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer or prescribed escalation protocol.
• Releases UM determinations to claim stakeholders following client-established protocols.
• Maintains all required UM review documentation in the UM software in a timely manner.
• Serves as first level contact for customer concerns pertaining to UM reviews.

USRN - Utilization Management Nurses

Permanent Work from Home Set-up

Salary P75,000 to P85,000 plus Signing Bonus P150,000

Qualifications:

• Holder of Active USRN License from any Mainland State
• With 2 years utilization management experience gained from working in the BPO industry or any US healthcare company
• Willing to work on night shift - rotational weekends off
• Must be residents of Greater Metro Manila area (provincial candidates outside of Metro Manila, Laguna, Cavite, Rizal and Bulacan will not be considered)