Quality Assurance Analyst - USRN | Healthcare

Gratitude Inc

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12 hours ago

Quality Assurance Analyst - USRN | Healthcare

2-3 Year(s)

80 - 120 Thousand p.m

Manila

Job Description

Key Skills

USRN 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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Quality Assurance Analyst – USRN (Healthcare)

TP Alphaland | Graveyard Shift | PHP 80K–120K

About the Role

Elevate clinical quality and compliance. As a USRN Quality Assurance Analyst, you’ll be the guardian of clinical accuracy, auditing nurse-driven reviews—Utilisation Management, Case Management, Triage, and more—to ensure every decision meets the highest U.S. healthcare standards. You’ll work onsite in Alphaland, following a graveyard shift, and play a critical role in shaping continuous improvement, coaching clinicians, and protecting patient safety. If you’re a detail-obsessed nurse with a passion for getting things right, this is your opportunity to lead quality from the front.

Key Responsibilities

Clinical Quality Monitoring & Evaluation

Audit nurse reviews and clinical transactions, including UM assessments, CM interventions, triage calls, medical necessity determinations, and clinical documentation. Validate adherence to MCG/Milliman, InterQual, CMS regulations, and client-specific criteria. Check ICD/CPT usage, medical necessity validation, and level-of-care appropriateness. Ensure documentation is complete, clear, and compliant.

Feedback Delivery & Coaching Support

Provide structured, timely feedback based on audit findings. Participate in one-on-one coaching with Operations Leaders, Trainers, and Clinical SMEs. Recommend corrective actions, training interventions, and reinforce proper clinical reasoning and documentation standards.

Reporting & Performance Analytics

Prepare clinical quality reports, error trending analyses, and calibration summaries. Identify patterns in clinical decisions, documentation, and guideline usage. Collaborate with Training and Ops to address systemic issues, conduct root-cause analysis, and drive improvement plans.

Compliance & Regulatory Adherence

Uphold HIPAA, client data privacy, and clinical documentation standards. Participate in calibration sessions, support internal/external audits, and maintain strict confidentiality at all times.

Process Improvement

Recommend enhancements to quality tools, audit forms, and clinical reference materials. Help improve clinical workflows, SOPs, and documentation guidelines. Support upskill and refresher programs, and contribute to clinical quality projects.

What You’ll Bring

Licensure & Foundation: Active PH Registered Nurse license plus a current, unrestricted USRN license.

Clinical Bedside Experience: Minimum 2 years in ER, ICU, Med-Surg, or Telemetry.

BPO & QA Experience: At least 1 year as a USRN in a BPO or U.S. healthcare account (UM, CM, Appeals, Triage) and prior experience as a Quality Analyst, Clinical Auditor, or Reviewer in a U.S. healthcare setting.

Guideline Mastery: Strong knowledge of MCG/Milliman, InterQual, HIPAA, U.S. medical terminology, and healthcare law/care coordination.

Administrative Expertise: Minimum 1 year handling medical accounts, medical data, or clinical documentation in a clerical or administrative support role.

Analytical & Communication Skills: Exceptional attention to detail, analytical thinking, and excellent English communication (verbal and written). Comfortable managing phone calls and high-volume email.

Tech & Adaptability: Proficient in MS Office and QA evaluation systems. Able to stay focused under pressure and adapt to shifting priorities. Familiarity with ICD-10/CPT coding is a plus.

Why Join Us

Join a team that treats quality as a shared mission. You’ll collaborate with clinicians, trainers, and leaders who are as dedicated to compliance and continuous improvement as you are. We offer competitive compensation (PHP 80K–120K), a culture of accountability, and the chance to directly impact patient outcomes through the power of precision.

How to Apply

Ready to audit excellence into every clinical interaction? Apply today and be prepared to share:

Educational attainment

Years of experience in medical accounts (clerical/administrative)

USRN license validity

Years of QA experience

Last drawn salary and expected salary

Let’s make quality care the standard—one audit at a time.

Role

Any Other

Timings

Night Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Functional Area

Any Other

Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.

Macdonald Cookey

Recruiter - Gratitude Inc

NA, nigeria

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