USRN Team Lead

Job Title: USRN Team Lead

Work Setup: Onsite Ortigas
Shift: Night Shift

We are looking for an experienced USRN Team Lead to lead a team supporting Utilization Management Review (UMR) operations in a healthcare BPO environment. The ideal candidate is an active US Registered Nurse with a strong acute hospital background hands-on UMR experience utilizing InterQual and MCG guidelines and proven leadership experience managing healthcare operations teams. This role is responsible for driving operational excellence ensuring clinical quality coaching team members and meeting client performance expectations.

• Lead coach and manage a team of clinicians to achieve quality productivity and service level targets.
• Monitor daily operations and ensure compliance with client requirements regulatory standards and internal policies.
• Provide clinical guidance and support on utilization management review cases using InterQual and MCG criteria.
• Conduct performance coaching quality reviews and regular feedback sessions to improve team performance.
• Manage team attendance scheduling and workload distribution.
• Handle escalations and resolve operational and clinical issues in a timely manner.
• Partner with Operations Quality Training and Workforce Management teams to drive continuous process improvement.
• Prepare operational reports and communicate performance metrics to leadership.
• Foster a collaborative high-performing and patient-focused work environment.

• Active and unrestricted US Registered Nurse (USRN) License (New York license preferred).
• Active Philippine Registered Nurse (PHRN) License.
• Minimum of 3 years of acute hospital experience preferably in Emergency Room (ER) or Operating Room (OR) settings.
• At least 1 year of Utilization Management Review (UMR) experience using InterQual and MCG clinical guidelines.
• Minimum of 2 years of Team Lead experience in a healthcare BPO environment.
• Strong leadership coaching and people management skills.
• Excellent verbal and written English communication skills.
• Strong analytical and critical thinking skills with the ability to make sound clinical decisions.
• Proficient in Microsoft Office applications and healthcare documentation systems.
• Willing to work onsite in Ortigas on a night shift schedule.