Utilization Review Nurse

Dynamic Talent Solutions

Дин35.4-44.2K[Monthly]
On-site - Taguig<1 Yr ExpBachelorFull-time
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Job Description

Benefits

  • Allowances

    Meal Allowance

  • Government Mandated Benefits

    13th Month Pay, Philhealth, SSS/GSIS

Description

The Reviewer is responsible for assessing the delivery of medical services to determine if the care provided is appropriate, medically necessary, and of high quality. This includes examination of documents to see if patients are given care consistent with their needs as well as inputting of approved Guidelines and References. The review typically involves medical records abstracting, analysis and documentation based on client-specific guidelines and templates.

  • Coordinates with the Production Supervisor and other Reviewers with regard to job assignment.
  • Evaluates completeness of submitted documents and identifies missing information that may support completion of utilization review request.
  • Constructs clear and accurate reviews of records that conform to the guidelines of each Client and determine if the care provided is appropriate, medically necessary, and of high quality. 
  • Applies ACOEM Guidelines and evidence-based references to certify or elevate to peer review requested procedures. Submits reviews for edit within a specified period.
  • Meets a target production output or quota and a quality standard to be set by Management.

Requirements

  • Graduate of Nursing
  • With or without experience
  • Amenable to work in shifting schedule
  • Willing to work onsite in Taguig
English LanguageMedical
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Mark Edward Delos Santos

HR OfficerDynamic Talent Solutions

Reply 1 Time Today

Working Location

Fort Bonifacio. Fort Bonifacio, Taguig, Metro Manila, Philippines

Posted on 01 July 2025

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