Training and Quality Manager (PHRN / USRN)

Nexus Recruitment Group; Pasig; On-site; PHP 700,000 - 1,000,000; Full time

Job summary

Nexus Recruitment Group seeks an experienced RN Training & Quality Manager to lead clinical training and quality initiatives for a US healthcare account. The role requires an active PHRN or USRN license and strong client-facing experience.

Expertise in InterQual, NCQA, and CMS standards is essential, with a background in training program management, quality audits, and utilization review including appeals and denials for Medicare plans. Onsite in Quezon City with US shift.

Qualifications

• Active PHRN or USRN license required.
• Experience in clinical training and quality audits.
• Utilization review including appeals/denials for plans (commercial/Medicare).
• Onsite, US-shift role based in Quezon City.

Responsibilities

• Lead clinical training and quality initiatives for the account.
• Ensure adherence to InterQual, NCQA and CMS standards.
• Oversee utilization review processes including appeals and denials.
• Collaborate with clients and internal teams to maintain training quality.

Skills

Client-facing

Quality management

Training programs

InterQual

NCQA

CMS standards

Education

RN license

Job description

Training and Quality Manager (PHRN / USRN)

About the job Training and Quality Manager (PHRN / USRN)

We are looking for an experienced RN Training & Quality Manager to lead clinical training and quality initiatives for a US healthcare account.

This role requires an active PHRN or USRN license, strong client-facing experience, and expertise in InterQual, NCQA, and CMS standards.

The ideal candidate has a background in managing training programs, quality audits, and utilization review processes, including appeals and denials for commercial and Medicare plans.

This is an onsite, US-shift role based in Quezon City.