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RN: Prior Auth Clinical Reviewer (Hybrid)

Company

Optum

Location

cebu city, Philippines

Type

Full-time

A leading health care technology company is seeking a US Registered Nurse to review medical requests and ensure services are necessary and compliant with clinical guidelines. Responsibilities include conducting clinical coverage reviews, coordinating with care teams, and documenting medical necessity assessments. Candidates must hold valid USRN and PHRN licenses, with a minimum of 2 years of hospital bedside experience preferred. Join a supportive team committed to innovation in health care and enjoy a hybrid work model post-training.
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