Quality Assurance Jobs - Page 51

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Quality Improvement Coordinator I

Michigan Health Plan - Troy, MI

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparat...

Director of Quality Management

Favorite Health Care Staffing - Kansas City, MO

A health insurance company in the KC metro area is looking to add a Quality Management Manager to their team! Job Summary: The Quality Management Manager develops, designs, and leads large scale quality management program work/projects encompassing performance assessment and improvement, governance systems, business process improvement, divisional project management (non-IT), operational and ex...

QA Auditor III

SunPower - Austin, TX

Do you want to change the world? We do, too. The energy market is roughly $4 trillion globally, and solar penetration is less than 1%. But just one hour of sunlight, if harnessed, could power the entire world for a year. We have the opportunity to completely change the way energy is produced, distributed and consumed on a global scale, and we're looking for talented, committed peo...

Senior Manager of Global Quality Management System

SunPower - San Jose, CA

Do you want to change the world? We do, too. The energy market is roughly $4 trillion globally, and solar penetration is less than 1%. But just one hour of sunlight, if harnessed, could power the entire world for a year. We have the opportunity to completely change the way energy is produced, distributed and consumed on a global scale, and we're looking for talented, committed peo...

Quality Improvement Coordinator I (RN preferred)

Bridgeway Health Solutions - Tempe, AZ

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparation...

Quality Specialist II (Call Center)

IT-Infrastructure - Clayton, MO

Position Purpose: Maintain a comprehensive working knowledge of policies, procedures and services in order to ensure the appropriate level of customer service is delivered. Ensure correct information is shared with all callers and outstanding customer and provider service delivered by phone and in writing. Identify and monitor trends and quality risks. Develop workf...

Quality Improvement Coordinator I (RN)

Home State Health Plan - Chesterfield, MO

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparation...

Quality Improvement Coordinator I (RN)

Bridgeway Health Solutions - Tempe, AZ

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives Schedule and assist with committee and sub-committee preparation. Assist in investigation and r...

Clinical Compliance Auditor

Magnolia Health Plan - Jackson, MS

Position Purpose: Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes Develop and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into the credentialing subsystem ...

Quality Improvement Coordinator I(RN preferred) (Columbus)

Buckeye Community Health Plan - Columbus, OH

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparation...

Quality Improvement Specialist II

Peach State Health Plan - Smyrna, GA

Position Purpose: Assist with the daily operations and support within the Quality Improvement department including data management, data reporting needs, and project management. Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality Assist in data collection, data entry and generation of ...

Quality Improvement Coordinator I

Michigan Health Plan - Troy, MI

Position Purpose: Analyze, develop, implement and monitor clinical QI initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparation...

Clinical Auditor (Medicare Part D)

US Script - Tempe, AZ

Position Purpose: Develop, conduct, administer and analyze clinical training programs, conduct audits of clinical systems entry and/or processes, and assist in development of audit tools. Develop and conduct Medicare D training based on audit findings Develop and maintain complex audit processes and audit tools related to authorizations, appeals, quality, star measu...

Credentialing/Delegation Specialist - Office Based

Superior Health Plan - Austin, TX

#LI-RA1 Position Purpose: Interface with delegated groups, complete required auditing and reporting related to delegation, and ensure adherence with NCQA requirements for assigned function. Conduct delegation audits for assigned function Communicate reporting requirements and related activities to delegated entities Ensure complian...

HEDIS Coordinator - QA

Superior Health Plan - Austin, TX

Position Purpose: Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas. Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results Establish and maintain an action plan to ...