Training Quality Manager (PHRN/USRN)

Recruitify_HR; Quezon City; On-site; PHP 424,080 - 613,800; Full time

Job summary

A healthcare recruitment agency is looking for a Training Quality Manager who will oversee the quality of training programs while ensuring compliance with healthcare standards. The candidate should possess a Bachelor's Degree in Nursing and have at least 2 years of experience in Utilization Management, alongside managerial experience. The role includes analyzing medical information, managing a team, and conducting training activities. Flexible onsite work schedules are required, including US hours and holidays.

Qualifications

• Active and valid license as a Professional Nurse (PHRN/USRN) required.
• At least 2 years of experience in Utilization Management.
• Minimum 2 years in a managerial position.
• Experience in training and quality management.
• Experience in a hospital setting or other clinical environment.

Responsibilities

• Oversee the quality of training programs and ensure compliance with healthcare standards.
• Manage utilization management and medical necessity approval and denials.
• Handle a team of leaders, TLs, and Supervisors.
• Conduct training and quality management activities.
• Analyze complex medical information and identify relevant clinical issues.
• Prepare appeal arguments and communicate with stakeholders.

Skills

Excellent verbal and written communication skills

Knowledge of InterQual

Knowledge of NCQA

Knowledge of CMS

Education

Bachelor's Degree in Nursing

Job description

Description

The Training Quality Manager is responsible for overseeing the quality of training programs and ensuring compliance with healthcare standards.

• Manage utilization management and medical necessity approval and denials.
• Handle a team of leaders, TLs, and Supervisors.
• Conduct training and quality management activities.
• Analyze complex medical information and identify relevant clinical issues.
• Prepare appeal arguments and communicate with stakeholders.
• Ensure familiarity with Medicare rules & regulations and guidelines.
• Work on-site with flexible schedules, including US hours and holidays.

Requirements

• Bachelor's Degree in Nursing with an active and valid license (PHRN/USRN).
• At least 2 years of experience in Utilization Management.
• Minimum 2 years in a managerial position.
• Experience in training and quality management.
• Experience in a hospital setting or other clinical environment.
• Knowledge of InterQual, NCQA, and CMS.
• Excellent verbal and written communication skills.