USRN / US Registered Nurse - Trainer, QA , Clinical Appeals , UMR

Full-time Bio & Pharmacology & Health

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

1. Develop, deliver and continuously update comprehensive training programmes for clinical and non-clinical staff on medical-surgical nursing practices, quality standards and compliance requirements
2. Manage and adjudicate clinical appeals, ensuring thorough review of medical necessity decisions and appro...