TA and QA Manager – US Healthcare Operations | HYBRID

TA and QA Manager – US Healthcare Operations | HYBRID 

Lead Quality. Elevate Training. Transform Performance.

📍 Location: Makati, Philippines
💻 Work Setup: Hybrid
🏢 Department: Operations – Contact Center & Claims
📊 Reports To: VP of Operations

Role Overview 

Great operations are built on great training and strong quality standards.

We are looking for a QA & Training Manager who can design, implement, and lead enterprise-level QA and training programs supporting U.S. healthcare operations across Contact Center and Claims Adjudication teams. This role works closely with U.S.-based client QA and training leaders to ensure calibration, alignment, and compliance with contractual quality standards.

Unlike traditional QA leadership roles, this position requires a hands-on operator mindset. The successful candidate must be willing to step directly into the operation when needed — facilitating training sessions, performing QA audits, supporting nesting teams, and even handling claims or calls to understand operational challenges firsthand.

If you believe the best leaders lead from the front, this role will be a great fit.

Key Responsibilities 

• Lead quality assurance and training programs supporting U.S. healthcare operations. 

• Develop and maintain standardized onboarding and certification programs for claims and/or contact center teams. 

• Conduct QA audits, side‑by‑side coaching, and training sessions to improve operational performance. 

• Support underperforming teams through targeted training and QA interventions. 

• Establish and maintain QA scorecards and ensure consistent scoring standards. 

• Participate in internal and client-facing calibration sessions to align quality expectations. 

• Analyze QA trends and identify root causes for errors, performance gaps, and training needs. 

• Partner with Operations leaders to implement improvement initiatives. 

• Track and report QA performance, training completion, and certification results. 

• Ensure training and QA processes comply with HIPAA and client-specific requirements. 
  

Qualifications 

• Minimum 5–7 years of experience in U.S. healthcare operations, particularly claims adjudication. 

• At least 2–3 years in a QA, training, or quality leadership role. 

• Strong knowledge of U.S. healthcare claims processing (Professional and/or Institutional). 

• Experience conducting QA audits and facilitating training or coaching sessions. 

• Ability to analyze quality trends and implement corrective training initiatives. 

• Strong communication skills and ability to collaborate with operations leaders and U.S. stakeholders. 

• Experience working in a healthcare BPO or offshore support environment is preferred. 

Core Competencies 

• Operational knowledge of U.S. healthcare claims 

• Quality assurance methodology 

• Training facilitation and coaching 

• Data-driven decision making 

• Cross-functional collaboration 
• Process improvement mindset 

What We Offer

🏥 Comprehensive HMO Coverage (Medical & Dental)
👨‍👩‍👧 Coverage starting Day 1 + 1 Free Dependent
💰 Hybrid Work Arrangement
📈 Opportunity to work with leading U.S. healthcare organizations

COMPANY OVERVIEW:

Imagenet LLC is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.