Job Requirements: 

• Candidates must possess a Bachelor’s Degree in Nursing. A holder of active and unrestricted licenses in both the Philippines and the US. 


• With experience in Utilization Review/Utilization Management 


• Applicants should be willing to report in Makati. 

Preferred not required: 

• With at least one (1) year of clinical experience    

Job Responsibilities:  

• Analyze and evaluate medical records and treatment plans to ensure they meet established medical guidelines and criteria for appropriate healthcare utilization. 


• Conduct thorough assessments of patients' medical needs, treatment plans, and progress to determine the appropriateness and efficiency of healthcare services provided. 


• Collaborate with healthcare providers, insurance companies, and other stakeholders to coordinate and manage patient care, ensuring the delivery of quality and cost-effective services. 


• Maintain accurate and detailed records of patient assessments, care plans, utilization review decisions, and other relevant information.  


• Ensure adherence to these regulations throughout the review process. 


• It's important to note that specific job responsibilities may vary depending on the healthcare setting, organization, and the specific needs of the role. 

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