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