Job Description: Join our growing healthcare team as a USRN Quality Assurance Analyst. You'll play a key role in maintaining service excellence by auditing healthcare interactions, ensuring compliance, and supporting operational performance through quality initiatives.

Responsibilities:

Perform quality evaluations and documentation reviews.

Ensure adherence to healthcare regulations and client requirements.

Deliver coaching insights based on audit findings.

Track quality metrics and identify improvement opportunities.

Partner with stakeholders to maintain high-quality service delivery.

Qualifications:

Active USRN license.

Experience in healthcare operations or quality assurance.

Excellent problem-solving and organizational skills.

Willing to work onsite and on a flexible schedule.

Non-Negotiable Requirements:

Non-Negotiable Requirements:

• PH Registered Nurse

• Registered Nurse with current, unrestricted US Registered Nurse license w/ BPO Experience and QA Experience

• Minimum 2 years of clinical bedside experience (ER, ICU, Med-Surg, Telemetry preferred).

• Minimum 1 year of USRN BPO or U.S. Healthcare experience in UM, CM, Appeals, Triage, or related clinical processes.

• Knowledge of MCG/Milliman, InterQual, clinical guidelines, HIPAA requirements, and U.S. medical terminology.

• Prior experience as a Quality Analyst, Clinical Auditor, or Clinical Reviewer in a U.S. healthcare account.

• Strong analytical skills with high attention to detail and documentation accuracy.

• At least one (1) year of experience in medical accounts for clerical or administrative support; someone experienced in handling or reviewing medical data or documentation

• Excellent English communication skills both verbal and written; must be comfortable in taking phone calls and high-volume emails.

• Ability to stay focused and adaptable under pressure and shifting priorities

• Knowledgeable in US Healthcare Law and Care Coordination

• Familiarity with coding systems (ICD-10, CPT) is a plus.

• Strong proficiency in MS Office tools and QA evaluation systems."

Take the next step in your healthcare career with a dynamic Quality Assurance team.