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US Registered Nurse Analyst (USRN) | PHP150,000* Signing Bonus (EH 1955)

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Experience icon1 - 3 years
Education iconBachelor
Job type iconFull-time

US Registered Nurse Analyst (USRN) | PHP150,000* Signing Bonus (EH 1955)

Log into view salary
Location iconmandaluyongExperience icon1 - 3 years
Education iconBachelorJob type iconFull-time
Posted on 30 November 2021

Job Description

Posted on 16 October 2021

  • Graduate of Bachelor of Science in Nursing (BSN)
  • Must have at least 3 months’ work experience as a Registered Nurse in a clinical setting
  • Must have an active USRN License
  • Holds current and unrestricted US Registered Nurse license (state-specific RN licensure)


Why join Accenture?


  • Php150,000* Signing Bonus*!
  • Competitive salary package, company bonuses, and performance incentives
  • Night differential
  • Loyalty, Christmas gift, Inclusion and diversity benefits
  • Paid sick and vacation leaves
  • Expanded maternity leave up to 120 days*
  • HMO coverage (medical and dental) from day 1 of employment
  • Life insurance
  • Employee stock purchase plan
  • Retirement plan
  • Flexible working arrangements
  • Accessible locations
  • Healthy and encouraging work environment
  • Career growth and promotion opportunities


*Terms and conditions apply

Requirements

  • Conduct post-service clinical claims review utilizing the member's benefit contract and health plan guidelines.
  • Completes review of pended post-service claims for appropriateness of treatment setting, contractual reviews, or medical necessity.
  • Utilize applicable client specific medical policy, client clinical guidelines, and/or client specific criteria sets (e.g., Milliman or InterQual), for decision making to either approve or summarize and route to Client's nursing reviewer and/or Client's medical staff for review.
  • Responsible for requesting additional clinical information as needed per client guidelines.
  • Accurately routes cases for client medical staff review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
  • 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 approve the medical appropriateness of services, throughout the clinical claim review process.
  • Facilitate accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
  • Determine contract and benefit eligibility.
  • Data entry into client systems and route as appropriate.


Skills / Software

NursingClinical WorkUSRNMedical

Working Location

Mandaluyong, Philippines

Job Description

minus
  • Graduate of Bachelor of Science in Nursing (BSN)
  • Must have at least 3 months’ work experience as a Registered Nurse in a clinical setting
  • Must have an active USRN License
  • Holds current and unrestricted US Registered Nurse license (state-specific RN licensure)


Why join Accenture?


  • Php150,000* Signing Bonus*!
  • Competitive salary package, company bonuses, and performance incentives
  • Night differential
  • Loyalty, Christmas gift, Inclusion and diversity benefits
  • Paid sick and vacation leaves
  • Expanded maternity leave up to 120 days*
  • HMO coverage (medical and dental) from day 1 of employment
  • Life insurance
  • Employee stock purchase plan
  • Retirement plan
  • Flexible working arrangements
  • Accessible locations
  • Healthy and encouraging work environment
  • Career growth and promotion opportunities


*Terms and conditions apply

Job Requirements

Plus
  • Conduct post-service clinical claims review utilizing the member's benefit contract and health plan guidelines.
  • Completes review of pended post-service claims for appropriateness of treatment setting, contractual reviews, or medical necessity.
  • Utilize applicable client specific medical policy, client clinical guidelines, and/or client specific criteria sets (e.g., Milliman or InterQual), for decision making to either approve or summarize and route to Client's nursing reviewer and/or Client's medical staff for review.
  • Responsible for requesting additional clinical information as needed per client guidelines.
  • Accurately routes cases for client medical staff review when a service or admission does not meet medical necessity, place of service, or benefit criteria.
  • 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 approve the medical appropriateness of services, throughout the clinical claim review process.
  • Facilitate accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
  • Determine contract and benefit eligibility.
  • Data entry into client systems and route as appropriate.


Skills / Software

Plus
NursingClinical WorkUSRNMedical

Working Location

Plus
Mandaluyong, Philippines

About the company

Overview Accenture is a leading global professional services company, providing a broad range of services and solutions in strategy, consulting, digital, technology and operations. Combining unmatched experience and specialized skills across more than 40 industries and all business functions—underpinned by the world’s largest delivery network—Accenture works at the intersection of business and tec...

IndustriesInformation Technology
Employees> 1000

Recruiter

Joanna Marie Gabay  
33% response rate, respond within 2 weeksLast active 29/11/2021
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