Utilization Review Nurse (USRN) - Morning Shift
International SOS Pasig Full-time
Job Title: Utilization Review Nurse (USRN)
Work Set-up: Onsite
Work Set-up: Onsite
Shift: Morning Shift
Basic Function:
The Utilization Review Nurse is responsible for facilitating healthcare services, reviewing the appropriateness of requested treatments, and determining coverage based on health insurance policies for U.S. Government civilian employees. The role ensures high‑quality case management, proper medical referrals, and accurate documentation while upholding confidentiality and ethical standards.
Key Responsibilities- Review medical treatment requests and assess coverage eligibility.
- Gather and evaluate clinical information to support case decisions.
- Coordinate referrals to appropriate facilities or specialists.
- Maintain accurate case documentation and uphold confidentiality.
- Collaborate with internal teams and international counterparts.
- PH and U.S. Registered Nurse licenses (valid ≥ 12 months).
- BS Nursing graduate.
- Minimum 5 years clinical experience; benefit review/BPO experience is a plus.
NTT Business Process OutsourcingQuezon City, 10 km from Pasig
Roles and Responsibilities
• Provides front-line supervision to an operational team of 35 or more employees
• Supervised team typically responsible for managing US healthcare Payer claims adjudication process
• Assigns work to direct reports.
Swift-UpPasig
Position Summary
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