USRN QA

Tata Consultancy Services; Taguig; On-site; PHP 800,000 - 1,200,000; Full time

Job summary

Tata Consultancy Services is seeking a USA-licensed nurse leader to oversee QA and clinical workflow quality in a fast-paced BPO environment in the Philippines.

The role emphasizes leadership, audits, coaching, reporting, and cross-functional collaboration to meet client SLAs and drive continuous improvement in healthcare operations.

Qualifications

• Active US Registered Nurse (USRN) license required.
• Minimum 3 years of clinical experience, preferably in Behavioral Health, Triage, or Case Management.
• Experience in training, precepting, or leadership in healthcare or BPO.
• Strong knowledge of U.S. healthcare systems, documentation standards, and regulatory requirements.
• Excellent communication, presentation, and stakeholder management skills.
• Strong analytical and problem-solving abilities.
• Proficiency in Microsoft Teams, LMS, and EMR systems (preferred).
• Excellent written and spoken English.

Responsibilities

• Lead staffing, scheduling, and coverage planning to optimize workforce.
• Serve as escalation point for internal teams and client-facing concerns.
• Monitor and ensure SLA adherence across triage and PA activities.
• Collaborate with Training, QA, and Sourcing to drive efficiency.
• Prepare and present reports on performance, risks, metrics to stakeholders.
• Conduct regular QA audits of clinical tickets.
• Evaluate ticket resolution, documentation, and escalation compliance.
• Provide actionable feedback to nurses and team leaders.
• Identify quality issues and recommend improvements.
• Support development and implementation of quality initiatives.
• Compile weekly and monthly QA audit reports and highlight trends.

Skills

USRN license

Leadership

Quality assurance

Stakeholder management

Healthcare systems knowledge

Communication

Analytical thinking

Team leadership

Tools

Microsoft Teams

LMS

EMR systems

Job description

The USRN QA Nurse Leader is responsible for overseeing quality assurance and operational excellence within clinical workflows. This role combines leadership, staffing management, and QA functions to ensure high-quality service delivery, compliance with standards, and achievement of client SLAs.

Key Responsibilities

Operations & Leadership

• Lead and manage daily staffing, scheduling, and coverage planning to ensure optimal workforce utilization
• Serve as the primary escalation point for internal teams and client-facing concerns
• Monitor and ensure adherence to SLAs across triage and prior authorization (PA) activities
• Collaborate cross-functionally with Training, QA, and Sourcing teams to drive operational efficiency
• Prepare and present regular reports on operational performance, risks, and key metrics to stakeholders

Quality Assurance

• Conduct regular audits of clinical tickets based on a pre-defined sampling methodology
• Evaluate ticket resolution accuracy, documentation quality, and compliance with escalation protocols
• Ensure adherence to clinical and regulatory standards in all reviewed cases

Coaching & Continuous Improvement

• Provide structured, actionable feedback to nurses and team leaders
• Identify recurring quality issues and recommend process improvements or training interventions
• Support the development and implementation of quality improvement initiatives

Reporting & Analytics

• Compile and present weekly and monthly QA audit reports
• Highlight trends, gaps, and opportunities for improvement to internal and client stakeholders
• Track performance metrics and recommend data-driven solutions

Qualifications

• Active US Registered Nurse (USRN) license (required)
• Minimum 3 years of clinical experience, preferably in:
• Behavioral Health
• Triage
• Case Management
• Proven experience in training, precepting, or leadership, ideally within a healthcare or BPO setting
• Strong knowledge of U.S. healthcare systems, documentation standards, and regulatory requirements
• Excellent communication, presentation, and stakeholder management skills
• Strong analytical and problem-solving abilities
• Proficiency in:
• Microsoft Teams
• Learning Management Systems (LMS)
• Electronic Medical Records (EMR) systems (preferred)
• Excellent written and spoken English communication skills
• Experience in quality assurance or clinical auditing
• Ability to lead teams in a fast-paced, high-volume environment
• Strong attention to detail and commitment to continuous improvement