Utilization Review Nurse - USRN Job at NTT DATA (Manila)

Clinical Reviewer Specialist

The Clinical Reviewer Specialist role involves conducting clinical reviews to pr...

Location

Philippines , Manila

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

1-3 years of experience in processing appeals or utilization management
US Registered Nurse (USRN)
Knowledge of utilization management process
Knowledge of NCQA, Medicaid regulations
Good communication (Demonstrate strong reading comprehension and writing skills)
Able to work independently, strong analytic skills
Required shift timings - US daytime

Job Responsibility

Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards
Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal
Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards
Communicates with providers, facilities and other departments regarding appeal requests
Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards
Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeal requests
Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices
Uses sound judgement, especially in non-routine appeals, to make decisions to keep the appeal process moving forward in accordance with contractual timeliness standards
Maintain files on individual appeals by gathering, analyzing and reporting verbal and written member and provider appeals
Review claim appeal for reconsideration and recommend approvals/denials based on determination level or prepare for medical review presentation

New

Process Engineer

An exciting opportunity has arisen for a Process Engineer to join our multi-disc...

Location

United Kingdom , Glascoed

Salary:

33.00 - 44.40 GBP / Hour

Outsource UK

Expiration Date

Until further notice

Requirements

HNC/HND (or higher) in Mechanical, Electrical, Manufacturing or Chemical Engineering
Good understanding of project and risk management tools and techniques
Strong communication, planning, and problem-solving skills
Proficiency in Microsoft Office and general engineering software tools
FULL SC clearance is required for this role

Job Responsibility

Develop and implement new manufacturing processes from concept through to commissioning and qualification
Support continuous improvement activities and process optimisation on existing products
Specify and qualify new equipment, ensuring compliance with safety and regulatory standards
Apply Lean principles, Process Control Plans, PFMEAs, and statistical techniques to maintain process capability and control
Coordinate technical documentation, trials data, and process definition through the company’s Product Lifecycle Management system

Fulltime

New

Recruitment Operations Professional

Recruitment Administrator. Contract: 12 Months. Based: Preston. Hourly rate: £15...

Location

United Kingdom , Preston

Salary:

15.24 GBP / Hour

Outsource UK

Expiration Date

Until further notice

Requirements

Experience working within recruitment operations (contingent recruitment desirable)
Strong understanding of recruitment processes and SLAs
Excellent IT capability, including Applicant Tracking Systems
Advanced Microsoft Office skills (particularly Excel)
Experience handling high-volume transactional activity

Job Responsibility

Managing the end-to-end onboarding process for contingent workers, ensuring first-day readiness
Providing timely updates to recruiters, hiring managers, agencies and candidates
Acting as a key point of contact for recruitment queries, escalating where required
Building strong relationships with stakeholders across the business and supply chain
Manipulating and analysing data to support reporting and improve process accuracy
Producing weekly billing and clocking reports with high attention to detail
Investigating and resolving billing discrepancies and data issues
Managing multiple live queries simultaneously while maintaining service quality
Supporting the implementation of new processes and continuous improvement initiatives
Ensuring compliance with internal SLAs, quality measures and HR processes

Fulltime

New

Shift Supervisor

We’re building a world of health around every individual — shaping a more connec...

Location

United States , Cresco

Salary:

16.50 - 24.00 USD / Hour

CVS Health

Expiration Date

April 09, 2026

Requirements

Deductive reasoning ability, analytical skills and computer skills
Advanced communication skills and supervision skills
Ability to work a flexible schedule, including some early morning, overnight and weekend shifts, to work overtime as needed, and to respond to urgent issues at the store when they arise

Job Responsibility

Work effectively with store management and store crews
Supervise the store’s crew through assigning, directing and following up of all activities
Effectively communicate information both to and from store management and crews
Assist customers with their questions, problems and complaints
Promote CVS customer service culture. (Greet, offer help, and thank)
Handle all customer relations issues in accordance with company policy and promote a positive shopping experience for all CVS customers
Maintain customer/patient confidentiality
Price merchandise
Stock shelves
Execute the displays, sign and inventory of weekly, promotional, and seasonal merchandise

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Parttime

New

Account Support Officer - Hardware

Contract – Account Support Officer – Hardware. Inside IR35 | Hybrid/London | Glo...

Location

United Kingdom , Greater London

Salary:

Not provided

Outsource UK

Expiration Date

Until further notice

Requirements

Customer-centric mindset with a service oriented approach
Strong process, task, and solution-focused working style
Highly organised and analytical with exceptional attention to detail
Demonstrable initiative and ability to work independently
Proficient in Microsoft Office
Strong written and verbal communication skills
Flexible approach to working hours to support a global business landscape
Experience working within distributed, international teams preferred
Operations or logistics experience within the games industry (or similar technical hardware environment) is advantageous

Job Responsibility

Provision development hardware schemes to new and existing game developers and partners via ticket support workflows
Manage local development hardware inventory, tracking logs, and hardware recalls
Collaborate on hardware security incidents and support their investigation and resolution
Coordinate with third-party vendors for logistics, shipping, and warehouse storage requirements
Resolve partner challenges relating to hardware access, allocation, and expansion requests
Support data integrity across internal tracking systems, reporting frameworks, and process improvement initiatives
Ensure partners comply with all applicable hardware security, access, and usage requirements worldwide

New

University Intern

Build upon your classroom studies through our Hotel Internship Program opportuni...

Location

India , Lucknow

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

Must be a current college or university student

Job Responsibility

Get immersed in Marriott's culture and business
Learn first-hand about a hotel's operations
Gain hands-on experience in hotel management
Deliver on the Fairfield Guarantee

Fulltime

New

Store Associate

Retail Store Associates play a meaningful role within the CVS Health family. At ...

Location

United States , Indianapolis

Salary:

15.00 - 19.00 USD / Hour

CVS Health

Expiration Date

March 22, 2026

Requirements

At least 16 years of age
Physical Requirements: Remaining upright on the feet, particularly for sustained periods of time
Lifting and exerting up to 35 lbs of force occasionally, up to 10 lbs of force frequently, and a negligible amount of force regularly to move objects to and from, including overhead lifting
Visual Acuity - Having close visual acuity to perform activities such as: viewing a computer terminal, reading, visual inspection involving small parts/details

Job Responsibility

Providing differentiated customer service by anticipating customer needs, demonstrating compassion and care in all interactions, and actively identifying and resolving potential service issues
Focusing on the customer by giving a warm and friendly greeting, maintaining eye contact and offering help locating additional items, when needed
Accurately perform cashier duties - handling cash, checks and credit card transactions with precision while following company policies and procedures
Maintaining the sales floor by restocking shelves, checking in vendors, updating pricing information and completing inventory management tasks as directed by store manager
Supporting opening and closing store activities, when needed
Providing customer support to all departments, including photo and beauty, ensuring departments are fully stocked and operational while remaining current with all updated services and tools
Assisting pharmacy personnel when needed, including working regular shifts in the pharmacy as part of opportunities for growth and career development
Embracing and advocating for new CVS services and loyalty programs that support our purpose of helping people on their path to better health

What we offer

Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance

Parttime

New

University Intern

Build upon your classroom studies through our Hotel Internship Program opportuni...

Location

Italy , Rome

Salary:

Not provided

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

Must be a current college or university student

Job Responsibility

Learn first-hand about a hotel's operations
Get immersed in Marriott's culture and business
Gain hands-on experience in hotel management

Fulltime

Utilization Review Nurse - USRN

NTT DATA

Location:
Philippines , Manila

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
March 03, 2026

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Utilization Review Nurse - USRN

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Location:Philippines , Manila

Category:Nursing

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Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:March 03, 2026

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Job Posted:
March 03, 2026