Job Title: USRN/ PHRN Team Leader

Shift: Night shift

Work Set-up: On-site in  Bridgetowne, Quezon City

Salary range:  70K to 120K, depending on the credentials

Start date:  Dec 31, 2025/ ASAP

Recruitment Process: 2  Virtual interview processes

QUALIFICATIONS:

• Bachelor's Degree in Nursing with an active and valid license in PHRN or USRN

• Minimum of 1 year InterQual criteria experience

• Minimum of 2 years bedside experience as an ER or ICU nurse (Acure Care bedside experience)

• Must have experience in utilization management with a US-based insurance company or hospital (or equivalent)

• Experience as a Team Lead or Supervisor for at least 1 year, in a similar support environment - other related roles exposed to related functions are also considered.

• Experience in a hospital setting or other clinical environment/ contact center setting 

• Excellent verbal and written communication skills

• Strong attention to detail and case documentation practices

• Ability to manage multiple cases and meet regulatory turnaround time under pressure

•  Proficient in basic Microsoft Office applications such as Word, Excel, and Outlook

•  Strong clinical knowledge, particularly in medical necessity review and interpretation of clinical documentation

•  Good knowledge and understanding of different healthcare insurance processes, appeals, grievances, and utilization management is preferred

• Willingness to work on-site with flexible schedules, including US hours and holidays

 

PRE-SCREENING QUESTIONS:

1. Do you have an active PHRN or USRN license?

2. How many years of experience do you have in InterQual criteria?

3. How many years of experience do you have in bedside care as an ER or ICU nurse?

4. Do you have a utilization management experience with a US-based insurance company or hospital (or equivalent)

5. How many years of Team Lead or Supervisor experience do you have in the BPO/CPO healthcare industry?

6. Please rate your knowledge and understanding of different healthcare insurance processes, appeals, grievances, and utilization management, from 1 to 10, 10 being the highest.

7. How much is your last drawn salary?

8. How much is your salary expectation?

9. Are you amenable to working onsite in Bridgetowne, Quezon City, with a night shift and fixed weekends off schedule?

10. When can you start once hired?