Utilization Review Medical Doctor

About the role

We are seeking a qualified Medical Doctor to join our healthcare operations team as a Utilization Review professional. In this fully onsite position, you will evaluate medical records and treatment plans to ensure services are appropriate, medically necessary, and aligned with clinical guidelines.

Key responsibilities

• Review patient medical records and documentation to assess appropriateness and necessity of services.
• Apply established clinical guidelines, medical references, and client‑specific criteria to evaluate cases.
• Perform medical record abstraction, documentation, and case outcome reporting.
• Assess treatment plans for compliance with quality and utilization standards.
• Maintain and update approved clinical guidelines and reference materials.
• Collaborate with internal teams to ensure timely and accurate case reviews.
• Uphold confidentiality and compliance with healthcare regulations.
• Contribute to process‑improvement and quality‑assurance initiatives.

Required profile

• Graduate of a Doctor of Medicine (MD) program; undergraduate medical graduates may also be considered.
• Experience in utilization review, clinical documentation review, healthcare quality, or related fields is an advantage.
• Strong knowledge of medical terminology and excellent attention to detail.
• Effective written and verbal communication skills in English.
• Willingness to work onsite in McKinley West Park, Taguig and to cover night shifts for US‑based clients.

Required skills

What we offer

• Competitive salary with incremental increases after training, probation, and regularization.
• Monthly meal and transportation allowance of Php 2,200.
• Full‑time permanent employment with a supportive team environment.