Deskripsi Pekerjaan
Career-Defining Opportunity for PHRN Professionals in Ortigas
Are you a licensed Philippine Registered Nurse (PHRN) looking to pivot your clinical career into a rewarding corporate role without leaving the healthcare field? We have an urgent opening for a PHRN Quality Analyst to support a premier US Healthcare account. This is your chance to utilize your nursing expertise, analytical skills, and passion for patient care in a dynamic Business Process Outsourcing (BPO) environment.
As a Quality Analyst, you will be the gatekeeper of clinical excellence. You will rigorously evaluate the quality of interactions between our healthcare advocates and US members, ensuring every touchpoint meets the highest standards of accuracy, empathy, and regulatory compliance (HIPAA, CMS, NCQA). Your insights will directly shape training programs, improve operational workflows, and ultimately enhance the health outcomes of thousands of patients across the United States.
This role is 100% onsite in our modern Ortigas office, allowing for close collaboration with operations, training, and client stakeholders. The nightshift schedule (US Business Hours) is accompanied by a premium compensation package that recognizes your specialized clinical skills.
Why You Should Apply:
- Top-Tier Compensation: Earn a competitive monthly package of up to PHP 50,000.
- Clinical Career Growth: Rare opportunity to move into Quality Assurance without leaving the clinical track.
- Global Exposure: Gain deep expertise in US Healthcare systems, insurance, and patient management.
- Comprehensive Benefits: HMO coverage for you and your dependents from day one.
- Stability & Culture: Work for a stable direct-hire account with a focus on employee well-being.
Ready to take your PHRN career to the next level? Join our team and make a tangible impact on healthcare quality.
Tanggung Jawab
- Conduct comprehensive audits of voice, email, and chat interactions to ensure accuracy and compliance with US Healthcare policies.
- Provide timely, effective, and constructive feedback to PHRN agents and team leaders to drive performance improvement.
- Identify root causes of quality issues and recommend process improvement initiatives to reduce errors and enhance the member experience.
- Ensure all interactions strictly comply with HIPAA, CMS, and other regulatory standards.
- Prepare and present detailed quality scorecards, trend analysis, and reports to management and clients.
- Collaborate with Training and Operations teams to design targeted interventions and coaching programs.
- Maintain up-to-date clinical knowledge and apply critical thinking to complex healthcare scenarios.
- Participate in client calibration sessions to ensure alignment on quality standards and expectations.
Kualifikasi
- Must be a Registered Nurse (PHRN) with an active PRC license.
- Minimum of 1 year of solid BPO experience handling a US Healthcare account.
- At least 1 year of experience as a Quality Analyst is highly preferred; experienced agents with strong scores are also encouraged to apply.
- In-depth knowledge of US Healthcare processes such as claims, billing, prior authorization, benefits verification, or clinical appeals.
- Excellent command of the English language, both written and verbal.
- Highly detail-oriented with strong analytical and root cause analysis skills.
- Willing to work 100% onsite in Ortigas and on a nightshift schedule.
- Proficient in Microsoft Office applications, particularly Excel and PowerPoint.