Medical Doctor (Utilization Review)

Job Expectations:

• Position Type: Associate - Individual Contributor
• Employment Type: Full-Time, Permanent (Direct Hire)
• Work Setup & Location: Fully Onsite - McKinley West Park, Taguig
• Work Schedule: Weekdays; Night Shift (US)
• Number of Headcounts: 4 FTEs Available
• Industry: Healthcare & Legal Outsourcing

About the Job:

We are looking for a Utilization Review Doctor to join the healthcare operations team and support the evaluation of medical services and patient care documentation. In this role, you will review medical records and treatment plans to determine whether the services provided are appropriate, medically necessary, and aligned with established clinical guidelines. You will analyze patient cases, document findings and recommendations, and help ensure compliance with client requirements, healthcare regulations, and quality standards.

Key Responsibilities:

• Review medical records and healthcare documentation to assess the appropriateness and medical necessity of services provided.
• Evaluate patient cases using established clinical guidelines, medical references, and client-specific criteria.
• Perform medical record review, abstraction, and documentation activities.
• Assess treatment plans and healthcare services to ensure alignment with quality and utilization standards.
• Accurately document review findings, recommendations, and case outcomes.
• Maintain and update approved clinical guidelines and reference materials as needed.
• Collaborate with internal teams to support timely and accurate case reviews.
• Ensure confidentiality and compliance with healthcare regulations and documentation standards.
• Contribute to process improvement and quality assurance initiatives related to utilization review.

Qualifications:

• Graduate of a Doctor of Medicine (MD) program; undergraduate medical graduates may also be considered.
• Previous experience in utilization review, clinical documentation review, healthcare quality, or a related field is an advantage.
• Strong knowledge and understanding of medical terminology.
• Excellent active listening, typing, and auditory processing skills.
• Ability to document accurately while listening to live patient consultations.
• Strong attention to detail and organizational skills.
• Good written and verbal communication skills in English.
• Willing to work onsite in McKinley, Taguig.
• Willing to work night shifts supporting US-based clients.

Basic Salary:

• For non-licensed: Php 25,000 during training and probationary period, Php 30,000 upon regularization

• For licensed: Php 25,000 during training; Php 30,000 during probationary period; and Php 35,000 upon regularization

Allowances: Php 2,200 / month (Meal & Transportation)

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