Quality Assurance Lead Nurse

About the Role

We are looking for a Quality Assurance Lead Nurse (known internally as a Near Patient Quality Assurance Lead) to champion high standards of patient care and drive continuous service improvement across our near patient nursing teams. In this home‑based role, you’ll work closely with global quality colleagues, TRICARE partners, beneficiaries, medical providers, and local teams to enhance customer experience, monitor quality performance, and ensure safe, effective service delivery. You’ll lead quality initiatives, oversee service recovery processes, analyse provider outcome data, and support audits, credentialing, and corrective action planning to uphold the TRICARE Overseas Program’s clinical quality standards.

This role is based from home, with occasional travel to healthcare provider sites in the region.

Key Responsibilities

• Lead quality initiatives, processes and oversight of customer service / service recovery responses, in partnership with the in-country teams.
• Ensure that documentation of compliments, complaints, grievances and Prevention Quality Indicators (PQI) are captured in our customer feedback system (RiskMan360) and track corrective action plans that result from investigations of grievances, Quality Incidents, customer feedback and defect trends.
• Responsible for driving support for the Clinical Management Program / Clinical Quality Oversight Plan through the collection, collation and analysis of provider level data relating to the quality outcome program.
• Support the Lead Country Physician in raising and maintaining the quality of the near patient nurses’ assessments through case reviews and case feedback.
• Support provider visits to develop relationships with the provider quality team, to support site assessment visits and to drive the regular update of clinical outcome data from providers.
• In consultation with the Clinical Quality Assurance and Innovation Lead and the Head of Clinical Quality define, implement, and administer key service quality guidelines and procedures.
• Set targets for improvements in service quality to drive up standards in beneficiary satisfaction and safety of care.
• Implement proactive service quality improvement plan and initiatives, ensuring all parties understand their role in the plan.
• Ensure patient expectations are met from start to finish and work with local healthcare providers and near patient teams where Patient Reported Experience Measures (PREMS) describe poor beneficiary centric care.
• Assist with targeted training of employees to ensure consistent and high-quality levels of customers service support.
• Conduct regular internal reviews on service delivery through case reviews and clinical audits, providing feedback to the teams, physician leads and the quality team.
• Work with the Head of Clinical Quality to ensure appropriate capacity and support in place to complete audits and conduct workshops / focus groups.
• Collaborate with other members of the quality team in preparing and implementing training and development plans and in mentoring country team.
• Assure that all appropriate personnel are trained on all SOP’s and that SOP’s are readily assessable to them.
• Participate in projects related to quality improvement initiatives.

About You

• Graduate nurse with a minimum of 3 years nursing experience
• Experience in one or more of the following fields:
  o Healthcare quality management/assurance
  o Medical facility accreditation in one or more areas
  o Implementation or conducting of medical facility or departmental review/audit programs
  o Medical facility administration in provision of healthcare services
  o Medical outsourcing of services to provider network
  o Healthcare network development / management
  o Familiarity/experience with international healthcare - either working/interfacing in
  international healthcare environment
  o Healthcare insurance or medical/travel assistance in area of managed healthcare utilizing
  provider networks
• Proficient in Korean and English
• Identifies and acts on potential problems and / or difficulties
• Demonstrates appropriate listening skills
• Demonstrates effective problem-solving skills and lateral thinking
• Able to work under pressure and to prepare accurate and timely reports

Why This Role Stands Out