USRN QA Specialist (El Paso & Hartford Account)
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Work Set-up/Location: Temporary WFH; with onsite reporting as needed at the nearest Shearwater site in any of the following locations: Cebu, Manila, Pampanga, or Davao Required License/Credentials: Active USRN license, any state Account Type: Non-Voice 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
Requirements 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