Earn P100,000 Signing Bonus! Nezda is looking for Utilization Nurse Reviewer – USRN.
💰 Salary: P50,000 – P70,000
❗️ Work from Home
Qualifications:
✅ Active and non-active USRN license
✅ With at least 1 Year of clinical or hospital experience
✅ USRN with RN license
Job Description:
👉🏻 We are in partnership with multiple companies for this position, so you have an option and which company fits you best.
👉🏻 Please take note that this is direct employment with no bond.
👉🏻 Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
👉🏻 Responsible for conducting medical management review activities that 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.