Work Environment Factors and Work Efficiency Among Filipino US Registered Nurses in Remote Utilization Management Roles in The United States Healthcare System

Remote Utilization Management has emerged as an alternative nursing role for Filipino United States Registered Nurses, yet evidence concerning their working conditions and efficiency remains limited. This study examined the relationship between work environment factors and work efficiency and developed an evidence-based training program. Methods: A quantitative descriptive-correlational design was used among 158 Filipino USRNs working in remote Utilization Management. Data were collected using a structured questionnaire measuring physical work environment, technological support, workload, organizational support, communication, work-life balance, leadership, productivity, accuracy, timeliness, decision making, and job performance. Frequency, percentage, mean, independent samples t test, analysis of variance, Welch’s analysis, and Pearson correlation were employed. Results: Respondents generally reported high levels of work environment and work efficiency. Physical work environment and technological support were the strongest workplace dimensions, while workload and work-life balance were comparatively lowest. Quality and accuracy emerged as the strongest efficiency dimension, whereas productivity was comparatively lowest. Work environment and efficiency differed significantly according to educational attainment, civil status, nursing experience, and remote Utilization Management experience, but not according to age or sex. All work environment dimensions had very strong positive relationships with productivity, accuracy, timeliness, decision making, and overall performance. Discussion: The findings indicate that favorable physical, technological, organizational, relational, and psychosocial conditions are integral to efficient remote nursing practice. The REMOTE-UM EXCEL Program was proposed to strengthen ergonomics, technology competence, workflow management, communication, evidence based decisions, leadership, psychological safety, and work-life boundaries. Organizations should implement integrated workplace interventions and evaluate their effects through longitudinal and performance-based measures to support sustained quality, employee well-being, and organizational effectiveness.