RNs are responsible for providing direct patient care, executing care plans, managing complex care systems, guiding care programs, and advising patients on maintaining health.

Minimum Hiring Qualifications:

• Must be a licensed Philippine Registered
• Nurse with at least 1 year of clinical experience plus 6 months in a clinical
• BPO or appeals/utilization management role.
• Strong clinical background, especially in medical necessity reviews, interpreting clinical documents, and understanding healthcare insurance processes (appeals, grievances, UM).
• Excellent communication skills, high attention to detail, strong case documentation habits, able to handle multiple cases and meet strict turnaround times.
• Proficient in MS Office and open to flexible schedules, including US hours and holidays.
• Preferred: Experience with Medicare Part C or US-based appeals, familiarity with CMS, NCQA, URAC guidelines, and exposure to appeals management platforms (e.g., VAM, Salesforce Health Cloud).

(RN's with exp in any BPO company is a plus)

SALARY IS UP TO 40K