- Location
- Quezon City
- Type
- Full-time
- Department
- Human Resources
- Experience
- 1+ years
- Education
- Bachelor
- Closing date
- Today
- Source
- CareersPage
Description
Training Specialist Qualifications
Department: Care Management Services (CMS)
Education
- Bachelor's degree in Healthcare Administration, Nursing, Business, Health Information Management, or related field preferred.
Experience
- Minimum 2 to 3 years of healthcare operations experience.
- At least 1 year of Quality Assurance, Auditing, Compliance, or Performance Improvement experience.
- Experience auditing Enrollment, Eligibility Verification, Insurance Validation, and Care Management workflows.
- Experience conducting root cause analysis and calibration sessions.
Technical Knowledge
- Knowledge of:
- Medicare and Medicaid guidelines
- Commercial insurance verification standards
- Healthcare documentation requirements
- Care Management workflows
- HIPAA and confidentiality standards
- Strong analytical and reporting skills.
Core Competencies
- Attention to detail
- Critical thinking
- Data analysis
- Coaching and feedback delivery
- Process improvement
- Risk identification
- Stakeholder management
- Strong written communication
Key Responsibilities
- Audit transactions, calls, cases, and documentation.
- Perform quality reviews against SOPs and client standards.
- Conduct calibration sessions with operations and training teams.
- Identify trends and performance risks.
- Provide coaching recommendations.
- Develop QA scorecards and audit tools.
- Track compliance and productivity metrics.
- Partner with Operations leadership to improve quality outcomes.
Preferred Metrics Experience
- Quality scores
- Audit accuracy rates
- Compliance adherence
- Error reduction trends
- Corrective action effectiveness
- Process improvement initiatives
Preferred Leadership-Level Competencies
Required
- Healthcare BPO or Healthcare Operations experience
- Strong understanding of Enrollment & Eligibility functions
- Knowledge of Care Management Services workflows
- Advanced Excel and reporting skills
- Project management capabilities
- Experience creating and maintaining SOPs
Preferred
- Lean Six Sigma Yellow Belt or Green Belt
- Certified Professional in Healthcare Quality (CPHQ)
- Certified Trainer designation
- Experience building quality and training programs from the ground up
Skills
ExcelComplianceProject ManagementSix SigmaHIPAA
