Quality Assurance Specialist
4 weeks ago
Carry out quality assurance oversight activities defined in the Client Managed Care National Best Practices and Quality Assurance Standards
Conduct regular and systematic review of Managed Care internal and external claim files with focus towards validation of consistent evaluation of evidence-based medicine, comprehensive assessments, proactive medical and disability management.
Reviews to focus on completion of activities and case management goals in timely manner, have appropriate follow up, appointments are made within recommended frequency, and ensure there are no gaps in service and medical care coordination.
Analysis of Quality Assurance reporting metrics to identify strengths, trending, and provide recommendations which can support and tie into education training development needs for the overall programs.
Measure and identify staffing competency levels from quality assurance reviews.
Work with leadership and staff to calibrate quality standards across all offices.
Qualifications:
Unrestricted active RN license
Bachelor's degree in nursing (BSN)
Certification in case management, rehabilitation nursing or related specialty preferred. Quality Assurance program designations such as Health Care Quality and Management certification (HCQM) highly preferred.
Minimum two (2) years direct clinical care required but not limited to trauma, emergency, intensive care, orthopedic, neurology.
Written and verbal fluency in English is required
Combination of two (2) years in either utilization review programs for Group Health or Worker's Compensation or experience in a quality assurance role required
Understanding and prior experience with URAC accreditation for utilization review is preferred.
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeJob Title: Quality Assurance SpecialistWe are seeking a highly motivated and detail-oriented Quality Assurance Specialist to join our team. As a Quality Assurance Specialist, you will play a critical role in ensuring the quality of our products and services.
-
Quality Assurance Specialist
3 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeQuality Assurance Specialist Job DescriptionAs a Quality Assurance Specialist, you will be responsible for conducting regular evaluations and assessments of customer interactions to identify areas for improvement.You will work closely with the management team to develop quality assurance strategies and processes, and provide detailed feedback and coaching to...
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeJob OverviewQuality Assurance SpecialistWe are seeking a highly skilled Quality Assurance Specialist to join our team. The ideal candidate will have a strong background in quality assurance, regulatory affairs, and quality management systems.Main Responsibilities:- Develop, implement, and maintain quality management system procedures, policies, and...
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeQuality Assurance SpecialistAs a key member of our team, you will play a crucial role in ensuring the highest level of quality in our assurance services. Your expertise will be utilized to monitor and enhance quality checks across various procedures performed by our teams globally.
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeJob Title: Quality Assurance SpecialistJob Description:We are seeking a skilled professional to fill the role of Quality Assurance (QA) specialist.This position is responsible for planning, developing, and implementing test strategies according to QA guidelines.The ideal candidate will have excellent communication skills and be able to work effectively in a...
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeJob Summary: We are seeking a detail-oriented and analytical professional to join our team as a Quality Assurance Specialist.This is an exciting opportunity for a recent finance graduate or a career changer looking to transition into a quality assurance role.
-
Quality Assurance Specialist
4 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeQuality Assurance SpecialistWe are seeking a highly skilled Quality Assurance Specialist to join our team. This role is responsible for managing business processes and customer service operations, as well as assisting in the development and implementation of divisional initiatives, policies, and procedures.Key responsibilities include:Managing the...
-
Quality Assurance Specialist
3 minutes ago
Taguig, National Capital Region, Philippines beBee Careers Full timeAs a Quality Assurance Specialist, you will play a vital role in ensuring the highest standards of quality are met in our organization.
-
Quality Assurance Specialist
3 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeQuality Assurance Specialist JobWe are seeking a Quality Assurance Specialist to join our team as a Channel Analyst.This role involves designing and executing test plans and scripts, recording and documenting results, detecting software failures, generating historical analysis of test results, developing and documenting application test plans, and creating...
-
Quality Assurance Specialist
5 days ago
Taguig, National Capital Region, Philippines beBee Careers Full timeQuality Assurance Specialist RoleWe are seeking a highly skilled Quality Assurance Specialist to ensure the highest quality of our products and services.This individual will be responsible for ensuring that all products meet the required standards, and resolving any issues that may arise during production.Responsibilities:Schedule adherenceMeet with...
