USRN QA Specialist

Level Up Business Process Outsourcing Services OPC; Pampanga; On-site; PHP 446,000 - 725,000; Full time

Job summary

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

The ideal candidate holds an active USRN license, bedside experience, and 1–2 years in Utilization Review/Utilization Management within a BPO/CPO

Qualifications

• Active USRN license from any U.S. state.
• At least 1 year bedside or relevant clinical experience.
• 1–2 years of Utilization Review/Utilization Management experience in BPO/CPO.
• Strong clinical judgment, attention to detail, and objective evaluation of outputs.
• Excellent 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

Active USRN license

Bedside clinical experience

Utilization Review

Utilization Management

Clinical judgment

Documentation

Analytical skills

Non-voice environment

Job description

Job Overview

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 is responsible for reviewing clinical process outputs, checking adherence to Utilization Review or Utilization Management standards, identifying quality gaps, and supporting continuous improvement across assigned healthcare processes.

The ideal candidate is an active USRN with bedside experience, Utilization Review or Utilization Management background, strong clinical judgment, and the ability to evaluate healthcare process outputs accurately and objectively.

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

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

Nice to Have

• Previous QA, audit, or quality monitoring experience
• Experience with scorecards, calibration, and quality reporting
• Background in U.S. healthcare payer or clinical process outsourcing accounts