QA & Training Manager (US Healthcare)

TL;DR

QA & Training Manager (US Healthcare): Designing and leading enterprise-level QA and training programs for U.S. healthcare operations with an accent on claims adjudication and contact center performance. Focus on establishing scoring standards, conducting calibration sessions with U.S. stakeholders, and implementing corrective training to resolve performance gaps.

Location: Hybrid in Makati, Philippines

Company

hirify.global is a leading provider of tech-enabled outsourced services and back-office support for healthcare plans across the United States.

What you will do

• Lead quality assurance and training programs for U.S. healthcare claims and contact center operations.
• Develop and maintain standardized onboarding and certification programs for operational teams.
• Conduct QA audits, side-by-side coaching, and targeted training interventions to improve performance.
• Establish QA scorecards and lead calibration sessions with internal and U.S.-based client stakeholders.
• Analyze QA trends to identify root causes for errors and implement corrective training initiatives.
• Ensure all training and QA processes comply with HIPAA and client-specific requirements.

Requirements

• 5–7 years of experience in U.S. healthcare operations, specifically within claims adjudication.
• 2–3 years of experience in a QA, training, or quality leadership role.
• Strong knowledge of Professional and/or Institutional U.S. healthcare claims processing.
• Proven experience in conducting QA audits and facilitating coaching or training sessions.
• Ability to collaborate effectively with U.S. stakeholders and operations leaders.
• Experience working in a healthcare BPO or offshore support environment.

Culture & Benefits

• Comprehensive HMO coverage (Medical & Dental) starting from Day 1.
• HMO coverage includes one free dependent.
• Hybrid work arrangement.
• Opportunity to work with leading U.S. healthcare organizations.