WE ARE HIRING!

CLINICAL OPERATIONS ASSISTANT MANAGER | USRN | ONSITE – VERTIS NORTH, QUEZON CITY

Program: Healthcare – Hybrid Voice and Back-Office Operations
Work Location: Vertis North, Quezon City
Work Setup: Onsite

Shift Schedule: US Day Shift

Salary: Open, depending on the candidate’s current or previous salary, experience, and qualifications. Salary expectations should remain reasonable and aligned with the client’s budget.

Target Start Date: On or before December 15

JOB OVERVIEW

Lead a high-performing clinical operations team supporting a major US managed care program. Drive service excellence, clinical quality, and team development in a fast-paced, metrics-driven environment.

KEY RESPONSIBILITIES

• Own daily SLA/KPI performance, including turnaround time, quality, productivity, and documentation.
  
• Conduct team huddles, interval monitoring, root cause analysis (RCA), and performance recovery planning.
  
• Ensure strict compliance with HIPAA and PHI requirements.
  
• Lead clinical quality assurance through audits, calibrations, coaching, and documentation reviews.
  
• Develop and mentor registered nurses (RNs), clinical associates, and team leaders.
  
• Manage competency programs, preceptorship, continuing education (CE) tracking, and license validity.
  
• Collaborate with Workforce Management (WFM), Talent Acquisition (TA), Quality Assurance (QA), and client stakeholders.
  
• Translate clinical protocol updates into practical workflows and training materials.
  

QUALIFICATIONS

• Bachelor of Science in Nursing (BSN) graduate with an active Philippine RN license.
  
• Active, unrestricted USRN license (NCLEX passed).
  
• At least 5 years of clinical and healthcare operations experience.
  
• At least 3 years of team leadership experience in healthcare BPO or shared services.
  
• Strong knowledge of US managed care, Utilization Management (UM), Case Management (CM), CMS, and HIPAA.
  
• Proven experience managing SLAs, KPIs, and clinical operational performance.
  
• Background in Utilization Review (UR)/Utilization Management (UM), with current experience managing UR operations.
  
• Experience in UM, CM, Health Risk Assessment (HRA), triage, or payer operations is preferred.
  
• Familiarity with URAC/NCQA standards is an advantage.
  
• Training experience is preferred.
  
• Willing to work onsite on a US day shift.
  

USRN LICENSE VALIDITY
The license must be active. Candidates whose licenses are nearing expiration must be willing to renew it.