GBSC - Clinical Program Nurse II

Crawford & Company
Full-time Manila, Metro Manila Other Management Occupations
Posted:
March 03, 2026
Location:
Manila, Metro Manila, Philippines

Job Description

Summary

Responsible for reviewing medical information to determine if requested treatment is medically necessary and appropriate according to the given standards.

Job Scope

  • Evaluation of Medical Information
    Analyzes medical information and applies established criterion to facilitate the utilization review process.
    Collaborates objectively with peer physicians to facilitate case resolution.
    Utilizes appropriate resources to perform utilization review process.
    Documents pertinent information in internal and external communications to support utilization management determinations and case resolutions.
    Adheres to the given standard operating procedures (SOP) and turnaround time to complete the review process.
    Demonstrates knowledge and understanding of Broadspire medical department policies and procedures and ability to communicate same with internal/ external customers as necessa...
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    Job Overview

    Job Type: Full-time
    Location: Manila, Philippines
    Posted: March 03, 2026
    Deadline: April 12, 2026