Make a Difference Beyond the Bedside
Are you a passionate Registered Nurse looking to leverage your clinical expertise in a rewarding, non-bedside role Join Sutherland as a Clinical Review Nurse (PHRN) and play a critical role in helping individuals navigate disability claims through accurate clinical assessments and meaningful collaboration with healthcare professionals and insurance teams.
This is an excellent opportunity for nurses who excel in medical record review, clinical analysis, and case management while enjoying career growth in a dynamic healthcare support environment.
What You'll Do
Clinical Assessment & Review
- Review and evaluate medical records, treatment histories, and supporting documentation related to disability claims.
- Analyze clinical information to determine medical relevance, consistency, and completeness.
- Identify missing information and recommend additional documentation when needed to support claim evaluations.
- Prepare concise, accurate, and comprehensive clinical summaries for case review.
Partner with Healthcare & Claims Teams
- Collaborate closely with disability adjudicators, claims specialists, and case managers to provide clinical insights that support informed decision-making.
- Communicate with physicians, healthcare providers, and other medical professionals to clarify diagnoses, treatment plans, and functional limitations.
- Serve as a trusted clinical resource for internal stakeholders by explaining medical findings and their implications.
Documentation & Reporting
- Maintain detailed, accurate, and compliant records of all clinical reviews and interactions.
- Develop professional reports that effectively summarize medical evidence and clinical conclusions.
Compliance & Quality Excellence
- Ensure all reviews are conducted in accordance with company policies, industry regulations, and legal standards.
- Stay current on evolving medical practices, clinical guidelines, and disability insurance regulations.
- Help drive quality, consistency, and accuracy throughout the claims review process.
What We're Looking For
Qualifications
- Active and valid Philippine Registered Nurse (PHRN) license.
- Bachelor's Degree in Nursing or a related healthcare field preferred.
- Minimum of 5 years of clinical nursing experience.
- Experience in clinical review, utilization review, medical case management, disability claims, insurance, or related healthcare settings is highly preferred.
- Strong clinical judgment and analytical skills.
- Excellent written and verbal communication skills.
- Ability to interpret complex medical records and communicate findings clearly and professionally.
Detail-oriented with a strong commitment to quality and compliance.
Why Join Sutherland
✅ Transition into a specialized nursing career beyond direct patient care
✅ Apply your clinical expertise in a meaningful and impactful way
✅ Collaborate with healthcare professionals and industry experts
✅ Expand your knowledge in disability and insurance clinical review
✅ Be part of a global organization that values innovation, growth, and employee development
If you're a skilled nurse with a passion for clinical analysis and evidence-based decision-making, we'd love to hear from you. Apply today and bring your expertise to a role where your clinical knowledge creates a lasting impact.
