Job Description

Be without limits! Explore career opportunities and stride success in a team that values all exceptional women! Celebrate Women’s Month with Accenture and get a chance to win *Lenovo Ideapad Laptop when you apply from March 1 to 31, 2023 and get hired before May 31, 2023! **Get hired and receive up to PHP200,000* Joining Bonus! Submit your application now and receive a call within 1 to 2 working days!** Duties and Responsibilities: • Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts. • 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. • 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. Qualifications: • 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 • Hybrid Work Set-up, but must be amenable to report in the office as needed *Terms and conditions apply *Salary will be based on the assessment and years of experience

Qualification Required

• College Graduate