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Utilization Review Nurse Manager

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NTT DATA

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Location:
Philippines , Manila

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Category:
Nursing

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

The Utilization Review Nurse Manager will oversee a team responsible for managing healthcare payer claims adjudication. This role requires a minimum of 5 years of relevant experience and strong leadership skills. The ideal candidate will have an undergraduate degree and be open to working night shifts. Join us to lead a dedicated team and ensure high-quality service delivery.

Job Responsibility:

  • Provides front-line supervision to an operational team of 35 or more employees
  • Supervised team typically responsible for manging US healthcare Payer claims adjudication process
  • Assigns work to direct reports
  • Recommends and takes actions hiring, firing, promotion, and disciplinary recommendations
  • Supervises team ensuring the highest quality of service is provided to clients
  • Monitors performance of the team and reports results and issues to higher-level leadership
  • Assists team with escalated client or account issues
  • Manages hiring, staffing and maintaining a diverse and effective workforce
  • Interacts with clients and internal departments to resolve issues
  • Works with the team to complete assignments using established guidelines, policies and procedures
  • Demonstrates professional courtesy and represents the company in a positive manner in all areas of internal and external communications
  • Ensures appropriate record keeping, reports, and related administrative functions are accurate and up-to-date
  • Responsible for career development / planning, performance and pay discussions of team members
  • Upon request, compiles and analyses data to identify trends for root cause analysis

Requirements:

  • Typically requires 5- 9 years relevant experience
  • Should be open to work in night shifts
  • Undergraduate degree or equivalent combination of education and work experience
  • Solid communication skills
  • Demonstrated client service skills and leadership capabilities
  • Good knowledge, understanding and application of project management principles and methodologies
  • Models excellent analytical / problem solving skills
  • Good client service skills and leadership capabilities
  • Solid analytical / problem solving skills

Additional Information:

Job Posted:
March 22, 2026

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