job description
Are you a dedicated US Registered Nurse (USRN) looking to elevate your career? Optum, a leader in global health innovation, is seeking passionate clinical professionals to join our high-performing team in Metro Manila. We are dedicated to evolving health care, ensuring everyone has the opportunity to live their healthiest life.
In this role, you will leverage your extensive hospital bedside experience to provide high-quality clinical assessments and medical case management. You will work in a fast-paced, technology-driven environment where your expertise directly impacts patient outcomes. We provide a supportive, inclusive workplace culture and industry-leading benefits, including Day 1 HMO coverage for your peace of mind.
If you are a USRN ready to transition into a global corporate environment while maintaining your clinical standards, we invite you to apply today and help us build a healthier future.
Responsibility
- Perform thorough clinical chart reviews and assessment of medical records for US-based patients.
- Utilize clinical knowledge to support medical necessity determinations and utilization management processes.
- Maintain compliance with HIPAA regulations and clinical guidelines at all times.
- Collaborate with cross-functional teams to ensure high-quality delivery of health care services.
- Provide clinical expertise during complex case evaluations.
- Document findings accurately in internal systems to support efficient patient care workflows.
- Stay updated on US healthcare regulations and clinical best practices.
Qualifications
- Active and valid US Registered Nurse (USRN) license (NCLEX-RN passer).
- Minimum of 2-3 years of solid hospital bedside clinical experience.
- Strong command of medical terminology and clinical assessment skills.
- Excellent written and verbal communication skills in English.
- High level of proficiency in computer navigation and medical record management software.
- Ability to work effectively in a corporate/BPO-style clinical setting.
- Strong analytical and critical thinking abilities.