(ACTIVE) USRN QA Specialist_Hybrid/TWFH | Non-Voice

USRN QA Specialist (Non-Voice)

Job Overview

We are looking for an experienced USRN QA Specialist to join our healthcare operations team. The ideal candidate should have strong clinical/bedside experience, hands-on experience in Utilization Review (UR) / Utilization Management (UM), and at least 1 year of Quality Assurance experience in a BPO/CPO healthcare environment.

Key Responsibilities

• Perform quality audits and reviews of healthcare-related processes and documentation.

• Monitor and evaluate the quality and accuracy of Utilization Review/Utilization Management activities.

• Identify process gaps, errors, and compliance issues and provide appropriate feedback.

• Ensure adherence to client-specific quality standards, policies, and procedures.

• Conduct regular quality checks and maintain accurate audit records.

• Provide feedback and coaching to team members based on audit findings.

• Support continuous improvement initiatives and help improve process quality.

• Maintain confidentiality and comply with healthcare and client requirements.

• Coordinate with operations and other stakeholders to resolve quality-related concerns.

• Prepare and maintain QA reports, scorecards, and performance metrics.

Qualifications

• Active USRN License with valid license status.

• At least 1 year of bedside nursing experience.

• 1–2 years of BPO/CPO experience in Utilization Review (UR) / Utilization Management (UM).

• At least 1 year of QA/Quality Assurance experience.

• Strong knowledge of healthcare processes, documentation, and quality standards.

• Good analytical, communication, and problem-solving skills.

• Willing to work in a shifting schedule.

• Willing to work in a Hybrid/Temporary Work From Home setup.

• Must be willing to work from the available sites in the Philippines.

Job Details

• Account: El Paso & Hartford Account

• Work Setup: Hybrid / TWFH

• Work Schedule: Shifting

• Location: BGC Taguig, Cebu, Davao, or Clark, Pampanga

• Start Date: ASAP

Recruitment Process

1. Validation

2. Talkpush Profile Creation

3. HR Interview

4. Hiring Manager Interview

5. Onboarding

Screening Questions

• What is your current location and preferred work site?

• Do you have an active USRN license? Please provide the license validity date.

• How many years of bedside nursing experience do you have?

• How many years of Utilization Review/Utilization Management experience do you have?

• How many years of QA experience do you have?

• What is your last drawn salary?

• What are your salary expectations?

• What is your notice period?