Utilization Management USRN Sr Analyst
Gratitude IncUtilization Management USRN Sr Analyst
Job Description
Key Skills
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Minimum Requirements:
• Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
• Holds a current and unrestricted US Registered Nurse license is required
• 3 months clinical experience (480 hours of working experience as a RN)
• must have at least one year of Utilization Management experience.
• Work experience as an active RN license and providing direct patient care
• Clinical setting includes inpatient hospital, outpatient hospital or community clinic
• No state license required
• Should be able to start by December 2025
• Ready to work full onsite in Taguig
• Open for those applicants who are currently in Philippines and already have the right to live and work in this country are eligible for this role
• Should not be a job hopper who only works for less than a year per company
Job Description
• Grievance & Appeals
• Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation.
• Creates a detailed case summary in narrative format for each appeal.
• Submits cases as directed for each applicable geographic region.
• Presents verbal and written case summaries to client’s Grievance Team and client Medical Directors.
• Completes assignments within client-designated turnaround times.
Role
Nurse
Timings
Flexible (Permanent)
Industry
Medical / Healthcare / Hospital
Work Mode
Work from office
Functional Area
Medical Professional / Healthcare Practitioner / Technician
Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.
Interview Tips
- Giving the VNA round?
- What are the most important skills you acquired as a Soft Skills/VNA trainer?
- How would you handle an irate customer?
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