Remote USRN QA Specialist — Healthcare Utilization Review

Level Up Recruitment; Philippines; Hybrid; PHP 420,000 - 640,000; Full time

Job summary

Level Up Talent Solutions is looking for a Lean-Pro USRN QA Specialist to support quality monitoring for non-voice healthcare operations accounts. This role reviews clinical process outputs for adherence to Utilization Review or Utilization Management standards, identifies quality gaps, and supports continuous improvement across assigned healthcare processes.

The ideal candidate is an active USRN with bedside experience and strong clinical judgment, capable of evaluating healthcare outputs

Qualifications

• Active USRN license from any U.S. state.
• At least 1 year of bedside or relevant clinical experience.
• At least 1 to 2 years of BPO/CPO Utilization Review or Utilization Management experience.
• Strong clinical judgment and attention to detail.
• Able to evaluate healthcare process outputs objectively and consistently.
• Strong documentation, reporting, and analytical skills.
• Comfortable working in a non-voice healthcare operations environment.

Responsibilities

• Review completed cases, transactions, or clinical process outputs for quality and accuracy
• Check adherence to Utilization Review, Utilization Management, documentation, and account standards
• Identify errors, missed steps, quality gaps, and process improvement opportunities
• Prepare QA findings, reports, and recommendations for operations and leadership teams
• Support calibration sessions to ensure consistency in quality standards
• Escalate recurring issues, compliance concerns, or process deviations when needed
• Maintain accurate QA documentation, audit records, and quality reports

Skills

USRN license

Bedside experience

Utilization Review/UM

Clinical judgment

Documentation/analytics

Job description

Level Up Talent Solutions is looking for a Lean-Pro USRN QA Specialist to support quality monitoring for non-voice healthcare operations accounts. This role reviews clinical process outputs for adherence to Utilization Review or Utilization Management standards, identifies quality gaps, and supports continuous improvement across assigned healthcare processes.

The ideal candidate is an active USRN with bedside experience and strong clinical judgment, capable of evaluating healthcare outputs