QA Nurse Auditor – Hybrid (Makati)

About the role

This full‑time hybrid position is based in Ayala, Makati and focuses on evaluating medical records, conducting clinical documentation reviews, and ensuring compliance with U.S. skilled‑nursing‑facility standards. The role supports pre‑authorization processes, coordinates with payers, and contributes to quality‑improvement initiatives.

Key responsibilities

• Perform medical record reviews to identify documentation gaps, risk areas, and compliance issues.
• Conduct internal quality‑assurance audits on nursing documentation and flag potential billing or coding discrepancies (Medicare/Medicaid focus).
• Identify survey risks, regulatory violations, and support corrective‑action plans.
• Review MDS‑related documentation for accuracy and completeness.
• Assist risk‑management initiatives, analyze incident reports, and ensure alignment with CMS, state, and facility regulations.
• Prepare QA summaries and reports for U.S. leadership.

Required profile

• Registered Nurse (RN) license in the Philippines.
• Minimum 5 years experience in a U.S. Skilled Nursing Facility.
• Strong background in utilization review, case management, or prior authorization.
• Fluent in English and Tagalog with strong written documentation and analytical skills.
• Previous remote work supporting U.S. healthcare clients is preferred.

Required skills

• Proficiency with Point Click Care (PCC) electronic health‑record system.

What we offer

• Competitive salary.
• Health and life insurance.
• 13th‑month salary and performance bonus.
• Hybrid work setup (3 days onsite, 2 days remote).
• Opportunities for pay raises and career growth.