Job Title: USRN QA Specialist (Non-Voice)

Account/s: El Paso & Hartford Accounts

Compensation: PHP 60,000 Fixed Package + Comprehensive Benefits

Work Setup: Hybrid / Temporary WFH | Shifting Schedule

Locations: BGC Taguig | Cebu | Davao | Clark, Pampanga

Headcount: 1 Opening (Immediate Start)

Elevate Clinical Quality Standards as a USRN QA Expert

Are you an active USRN with a sharp eye for clinical accuracy and Utilization Management guidelines? We are seeking 1 USRN QA Specialist to oversee quality assurance for our non-voice El Paso and Hartford Accounts. Step into an impactful auditing role where your clinical oversight ensures compliance, drives operational excellence, and directly influences team performance.

Core Responsibilities

• Clinical Auditing & Compliance: Conduct detailed quality reviews on non-voice Utilization Review and Utilization Management cases to ensure adherence to medical necessity guidelines and client SLAs.

• Targeted Coaching & Feedback: Identify trend errors, analyze performance metrics, and deliver constructive 1-on-1 feedback and coaching to clinical specialists.

• Process Improvement: Collaborate with operational leaders to refine clinical workflows, uphold strict US healthcare compliance, and maintain top-tier audit scores across both accounts.

What We Look For

Required Credentials:

• Active USRN License (Any US State or Territory) in good standing.

Required Experience:

• 1+ year of bedside, clinical, or hospital nursing experience.

• 1 to 2 years of Utilization Review (UR) or Utilization Management (UM) experience in a BPO/CPO setting.

• 1+ year of direct Quality Assurance (QA) or auditing experience in healthcare operations.

Only 1 slot available. Click Apply Now to secure this high-priority quality oversight role!