US Registered Nurse (USRN) | ₱100K Joining Bonus | Onsite Cubao
We're hiring US Registered Nurses to join our team as Health Clinical Services Senior Analysts.
What you'll do
- Review pre-service, concurrent, retrospective, and out-of-network requests — confirming the right care is delivered in the right setting, in line with medical policy, member benefits, and eligibility
- Apply established clinical criteria (InterQual, MCG/Milliman) and client guidelines to approve cases, or summarize and route them to the client's nurse reviewers and medical staff
- Escalate cases accurately when medical necessity, place of service, or benefit criteria aren't met — you will not issue denial determinations
- Consult with clinical reviewers and US-licensed medical directors to keep care appropriate, high-quality, and cost-effective
- Partner with providers to spot discharge needs early and support smooth care transitions across the healthcare continuum
What you bring
- Active, unrestricted US Registered Nurse (USRN) license
- Active PRC Philippine Registered Nurse (PHRN) license
- Bachelor of Science in Nursing
- Hands-on clinical experience as a practicing RN — bedside, inpatient, outpatient, or community clinic
- Utilization Management or clinical review experience is a strong plus
- Amenable to working night shift at our Quezon City site
The setup
- Schedule: Night shift
- Rest days: Weekends off
- Site: Quezon Cyberpark Tower 3, Quezon City
Ready to apply your license differently? Click apply and our Recruitment Team will reach out within 24–48 hours.