USRN Quality Analyst

This role is responsible for ensuring consistent adherence to the organization’s quality policy and clinical quality objectives. As a USRN Clinical QA, you play a key role in safeguarding the accuracy, completeness, and clinical integrity of all work produced by the operations team.
You help the business unit meet its Service Quality Plan by executing activities across all areas of quality management—quality planning, quality assurance, quality control, quality reporting, and continuous quality improvement. Through these responsibilities, you support a seamless and reliable experience for both internal stakeholders and external partners.USRN Quality Analyst

DUTIES & RESPONSIBILITIES:

Performance Management:

• Responsible for monitoring in an objective fashion all customer contact points. (Web, voice, e-mail, white mail)

• Responsible for reporting all behavior that does not conform to the quality standards set by the company and the account management.

• Designs and implements reports to establish patterns and trends of quality issues as they may arise.

• Provides quantifiable data to all quality judgments that are made.

• Works with operations as an auditor as well as regulator of quality issues.

• Works with Training and Operations to provide trend reports to address any issues that need refresher training.

• Conducts calibration session with the client and with Operations.

• Conducts product specific coaching sessions with the agents regarding trends and quality.

• Responsible in releasing updates and training flashes to Operations and Training group.

• Handles incoming calls and/ or escalated calls and meets telephone productivity standards. 

• Follows other tasks and/ or offline tasks assigned by his Training/ Quality Managers.

Process Improvement:

• Offers suggestion for continuous improvement of processes and systems

General Safety and Security

• Protects the organization’s assets by upholding the principles of the Quality Information Security Management System (QISMS)

• Ensures confidentiality, integrity, and availability of information critical to fulfilling the organization’s business functions

• Remain compliant with the relevant business, local and international regulatory and legislative requirements particularly the Health Insurance Portability and Accountability Act of 1996 (HIPAA), HITECH Act and URAC

COMPETENCY REQUIREMENTS:

With Basic Competency Level in the ff.:

Excellent interpersonal skills Ability to understand and interpret policy provisions.  Product knowledge Typing Skills Problem Solving Skills

With Moderate Competency Level in the ff.:

US Healthcare Delivery System Philippine Healthcare Delivery System Clinical Skills US Healthcare 101 Customer Service orientation Computer literate Interpersonal Skills Sense of Urgency Passion for Excellence

Calibration

• Conduct calibration sessions with the client and Operations teams.

Reporting

• Design and implement reports showing patterns and trends in Quality and CSAT.
• Provide Training and Operations with trend reports for refresher or newly‑discovered issues.
• Submit accurate and timely quality reports to the Quality Lead/Manager.
• Report any behavior that does not conform to Quality and CSAT standards.

Disclaimer

• The above statements describe the general nature and work level of this role. They do not list all responsibilities. Employees may perform other duties as assigned.
   

OTHER REQUIREMENTS:

Reports to: 

Quality Supervisor/Lead

Education and/or Experience:

• Preferably an Active Philippines Certified Registered Nurse (RN) with minimum 2 years post education clinical experience.

• Or Graduate of any 4-year course, preferably of a life-science course with 1 – 2 years of relevant work experience gained in a customer service-oriented environment

Certificates, Licenses, Registrations:

• Active Philippines Registered Nurse (RN) License;

• For USRN Lines of Businesses: Unrestricted US Registered Nurse License (Mainland US and US Territories), with 1-year post education clinical experience;

Language Skills:

English, additional language a plus. Strong communication and interpersonal skills.

Computer Skills:

MS Office.

Work environment:

• The work environment is professional, office.

• Business casual attire.

Physical demands:

• May require weekend, evening or shifting work schedule.

Quezon City, Bridgetowne ZetaPhilippines