Job Description
About the role
Nezda Technologies, Inc. is seeking a USRN / US Registered Nurse - Trainer, QA, Clinical Appeals, or UMR to join our healthcare operations team. This is a full-time position based in Metro Manila . In this strategic role, you will serve as a bridge between clinical excellence and operational quality, leveraging your nursing expertise to train staff, ensure quality standards, manage clinical appeals, and oversee utilization management review processes. You will play a crucial role in maintaining the highest standards of patient care and regulatory compliance across our organization.
Key responsibilities
- Develop, deliver and continuously update comprehensive training programmes for clinical and non-clinical staff on medical-surgical nursing practices, quality standards and compliance requirements
- Manage and adjudicate clinical appeals, ensuring thorough review of medical necessity decisions and appro...
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