USRN Utilization Management Program Manager-WFH

USRN Utilization Management Program Manager

Location: BGC Taguig, Cebu, Davao, or Clark, Pampanga, Philippines

Work Arrangement: Temporary Work From Home

Schedule: Shifting Schedule

Compensation: PHP 75,000–85,000 package

Employment Type: Full-Time

Position Overview

We are seeking an experienced USRN Utilization Management Program Manager to provide

clinical leadership and operational oversight within a healthcare operations environment.

The ideal candidate will be an active US Registered Nurse (USRN) with substantial Utilization

Management experience, recent clinical or hospital experience, and a proven track record in supervisory or managerial roles.

This position requires a strong clinical subject-matter expert who can lead teams, support

operational performance, and apply clinical and professional expertise to achieve quality and business objectives.

• Key Responsibilities Provide clinical and operational leadership for the assigned healthcare program. Lead, coach, mentor, and manage team members to achieve performance and quality objectives.
• Apply clinical expertise and Utilization Management knowledge to support effective process execution and decision-making.
• Monitor team and program performance against established operational and clinical standards.
• Serve as a clinical subject-matter expert for complex cases, processes, and operational concerns.
• Identify performance gaps and implement appropriate corrective and improvement initiatives.
• Ensure adherence to established healthcare, quality, compliance, and operational requirements.
• Collaborate with cross-functional teams to resolve issues and improve service delivery. Analyze operational trends and recommend process improvements.
• Provide regular performance updates, insights, and recommendations to management. Support continuous improvement initiatives and overall program success.

Required Qualifications

Active USRN license in any U.S. state.

At least 1 year of recent and relevant clinical, hospital, or similar healthcare experience. At least 2 years of Utilization Management experience.

At least 2 years of recent supervisory or managerial experience.

Strong clinical subject-matter expertise with the ability to apply technical and professional knowledge to achieve results.

Strong leadership, communication, analytical, and problem-solving skills.

Demonstrated ability to manage teams and drive operational performance.

Ability to work effectively in a fast-paced healthcare environment.

Willingness to work a shifting schedule.

Willingness to work from the assigned Philippine location when required.

Pay: Php70,000.00 - Php80,000.00 per month

Application Question(s):

• . Are you currently a Registered Nurse in the United States (USRN)?
• How much recent and pertinent clinical, hospital, or similar healthcare experience do you have?
• . How much hands-on Utilization Management (UM) experience do you have?
• . How much recent and pertinent supervisory or managerial experience do you have?
• Which best describes your level of Clinical Subject Matter Expertise?
• How have you primarily used your clinical knowledge in your professional experience?
• 7. Which best describes your Utilization Management experience?

No UM experience
UM-related training only
Assisted a UM team but did not independently handle UM responsibilities
Handled UM-related tasks for less than 2 years
Independently handled Utilization Management responsibilities for at least 2 years.

• 8. Which best describes the type of work you have performed in Utilization Management?

No UM-related work
Only administrative/data-entry tasks related to UM
Only handled claims or billing without UM responsibilities
Worked in a healthcare setting but had no UM responsibilities
Performed hands-on UM activities requiring clinical/medical knowledge and application of established healthcare/utilization criteria or processes for at least 2 years.

• 9. Which best describes your supervisory/managerial experience?

No leadership experience
Informal leadership only, without direct supervisory responsibility
Acting/temporary Team Lead experience only
Less than 1 year of formal supervisory/managerial experience
1 year to less than 2 years of formal supervisory/managerial experience
At least 2 years of recent and pertinent formal supervisory/managerial experience.

• 10. Which best describes your previous leadership responsibilities?

I have never supervised employees.
I served as a senior/tenured individual contributor but did not supervise employees.
I provided peer coaching but had no formal supervisory authority.
I temporarily acted as a supervisor/team lead but did not have sustained formal supervisory/managerial responsibility.
I have formally supervised or managed employees and was accountable for team/operational performance for at least 2 years.

• 11. Are you willing and able to work on a shifting schedule?
• 12. Are you willing to work under a temporary Work-From-Home (WFH) arrangement?
• 13. Are you able to work from/support the client's required locations in the Philippines when onsite reporting is required?
• 14. Which site are you amenable to reporting to once required to work onsite?

Cebu
Taguig, Manila
Davao City
Pampanga
Outside Philippines

• 15. If selected, when can you start?

Work Location: On the road