Quality Assurance Analyst - US Reristered Nurse | Healthcare

Gratitude Inc

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1 month ago

Quality Assurance Analyst - US Reristered Nurse | Healthcare

2-5 Year(s)

₱ 100 - ₱ 120K p.m

Manila (Makati, Pasig, Cubao Quezon City)

Job Description

Key Skills

USRN PH - Registered Nurse US Registered Nurse bpo USRN License QA SKILLS * Above average communication skills Proficiency in MS Office reviewing medical data or documentation Medical Account for clerical or administrative support;

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USRN Quality Assurance Analyst – Healthcare

TP Alphaland | Night Shift | ₱80,000 – ₱120,000 | Headcount: 2

We are hiring experienced USRN Quality Assurance Analysts to drive clinical excellence and ensure compliance across U.S. healthcare operations. This role is ideal for detail-oriented nurses passionate about quality, accuracy, and continuous improvement in a high-impact environment.

Key Responsibilities:

Perform audits on Utilization Management, Case Management, triage calls, and medical necessity reviews
Ensure adherence to U.S. healthcare standards (MCG/InterQual, CMS, HIPAA)
Evaluate clinical documentation, coding accuracy (ICD-10/CPT), and care appropriateness
Deliver actionable feedback and support coaching for clinical teams
Analyze quality trends, prepare reports, and support performance improvement initiatives
Participate in calibration sessions and assist with internal/external audits

Qualifications:

Active PH RN license and current, unrestricted USRN license
2+ years bedside experience (ER, ICU, Med-Surg preferred)
1+ year U.S. healthcare/BPO experience (UM, CM, Appeals, Triage)
QA, clinical auditing, or reviewer experience required
Strong knowledge of MCG, InterQual, HIPAA, and U.S. healthcare practices
Excellent analytical, communication, and documentation skills
Proficiency in MS Office and QA tools

Role

Nurse

Timings

Day Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Functional Area

Medical Professional / Healthcare Practitioner / Technician

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