US Registered Nurse – Clinical Review & Utilization

About the role

We are looking for a US Registered Nurse (USRN) to review and evaluate medical records, support utilization management activities, and coordinate care with healthcare providers. The role focuses on ensuring clinical documentation meets established guidelines and contributes to positive member outcomes.

Key responsibilities

• Review and evaluate medical records, clinical documentation, and other healthcare information based on established guidelines and protocols.
• Apply clinical knowledge and nursing judgment to support appropriate healthcare services and member outcomes.
• Assist with utilization management, utilization review, care coordination, or case management activities as assigned.
• Review patient/member information for completeness, accuracy, and clinical relevance.
• Coordinate with healthcare providers, members, and internal teams regarding clinical information and service needs.
• Communicate professionally with U.S.-based healthcare stakeholders through phone, email, and other channels.
• Document clinical reviews, decisions, interactions, and recommendations accurately in designated systems.
• Follow client policies, regulatory requirements, clinical guidelines, and standard operating procedures.
• Maintain confidentiality and comply with applicable healthcare privacy and data protection requirements.
• Meet established quality, productivity, accuracy, and turnaround‑time expectations.

Required profile

• Active US Registered Nurse (USRN) license in good standing.
• Bachelor’s degree in Nursing.
• Minimum 2 years of hospital experience.

What we offer

• 20% night differential.
• HMO coverage starting on day 1.
• Performance incentives.
• 14th month pay.
• Rice allowance.
• Salary package ranging from $50,000 to $65,000.