Compliance and Quality Manager

7 days ago


Taguig, National Capital Region, Philippines Gratitude Philippines Full time

**Quality Assurance Specialist Job Description:**

Gratitude Philippines is seeking a dedicated Quality Assurance Specialist to join our team. As a key member of our quality assurance team, you will be responsible for conducting quality assurance oversight activities, reviewing managed care internal and external claim files, and analyzing quality assurance reporting metrics.

**Responsibilities and Duties:

  • Conduct regular quality assurance reviews of managed care internal and external claim files to ensure compliance with established guidelines and regulations
  • Analyze quality assurance reporting metrics to identify areas for improvement and develop recommendations to enhance quality assurance practices and outcomes
  • Collaborate with cross-functional teams to achieve quality assurance objectives and improve patient outcomes
  • Develop and implement quality assurance processes and procedures that align with the Client Managed Care National Best Practices and Quality Assurance Standards
  • Maintain accurate and detailed records of quality assurance activities and findings

**Requirements and Qualifications:

  • Active RN license
  • Bachelor's degree in nursing (BSN)
  • Certification in case management, rehabilitation nursing or related specialty preferred
  • Minimum two (2) years direct clinical care experience required
  • Excellent communication and interpersonal skills


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