Job Description:
Accenture’s culture of equality nurtures innovation. We are committed to achieving a gender balanced workforce by 2025. Be part of the future workforce. Join us! We’re looking for a U.S Registered Nurse, what does it take to become one?
Think of yourself as the person who is responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
As a U.S Registered Nurse, you will be responsible in the tasks below:
Conduct post-service claims review utilizing the member's benefit contract and health plan guidelines. Completes review of suspended post-service claims for medical necessity or contractual reviews. 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 for client medical staff review when a service or admission does not meet medical necessity, place of service, or the 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 review managers and/or U. S. – licensed. Minimum Qualifications:
150k Signing Bonus! We're looking for an experienced professional with the skill set below: Holds current and unrestricted US Registered Nurse license. Holds state specific RN licensure as required. Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma. Senior level positions open, with 100k signing bonus. Must have at least 2 years’ clinical experience OR 1-year related Accenture or other outsourcing Clinical Health Management experience OR returning CL 10 employee. Just indicate in your application if you previously worked at Accenture. Clinical experience is defined as prior working experience as a Registered Nurse in a clinical setting.
Working experience as a Registered Nurse means holding an active RN license and providing direct patient care.
Clinical setting includes inpatient hospital, outpatient hospital or clinic. For voice accounts, must pass US Berlitz B2 level or Versant score of 58 and above. Proficiency in basic computer knowledge with the ability to learn additional computer programs. Working Location: – Eastwood QC or BGC Taguig
Work Schedule: Night Shift 9PM to 6AM
*What we offer: Be part of one of the biggest and most stable organization in the world Healthcare Insurance (HMO) & Life Insurance coverage from day 1 of employment Expanded maternity leave up to 120 days* Flexible Working Arrangements Employee Stock Purchase Plan Healthy and Encouraging Work Environment Allowances Loyalty, Christmas Gift, Inclusion and Diversity Benefits Night Differential • Retirement Plan *Terms and conditions apply The company provides an equal opportunity employment and welcomes applications from all sections of society and does not discriminate on grounds of race, religion or belief, ethnic or national origin, disability, age, citizenship, marital, domestic or civil partnership status, sexual orientation, gender identity, or any other basis as protected by applicable law.
