US Registered Nurse | Care Management  

Permanent Work From Home after three (3) months of onsite training!

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Accenture in the Philippines is currently looking for US Registered Nurse Analyst who will be responsible in performing the following day-to-day tasks:

• Utilize client specific criteria sets (e.g., Milliman or InterQual), applicable client specific medical policy and client clinical guidelines for decision making to either approve or summarize and route to Client's nursing reviewer and/or Client's medical staff for review.
• Accurately routes cases to client medical staff for further 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 ensure medically appropriate, high quality, cost effective care throughout the medical management process.
• Complete required clinical education hours needed to maintain active licensure/certification.

Fixed Weekends Off

What are we looking for?

• Graduate of Bachelor of Science in Nursing (BSN)
• Must have an active, unrestricted United State (US) registered nurse license
• Must have at least three (3) months of prior working experience as a registered nurse in a clinical setting