- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** SHP Pharmacy Quality Assurance - Auditing Specialist (Remote, hybrid or in office) ... pm (United States of America) **Job Description:** **JOB SUMMARY** The SHP Pharmacy Quality Assurance /Auditing Specialist monitors, performs, and manages … more
- State of Nevada (NV)
- QUALITY ASSURANCE SPECIALIST 2 APPROXIMATE ANNUAL SALARY - $58,025.52 to $86,150.88 PAY GRADE: 35 For more information on benefit and retirement programs, ... Services Division (ADSD) is currently recruiting for a full-time Quality Assurance Specialist II vacancy...Outcome Measures, Medicaid guidelines and/or Centers for Medicaid and Medicare Services regulations in a health care setting or… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. Summary: The RN Quality Assurance Specialist will oversee the clinical documentation of the ... direct care clinical staff to ensure it is compliant with Medicare , Medicaid/state/federal regulations, and agency policies and guidelines; works closely with… more
- Penn Medicine (Philadelphia, PA)
- …performed. (HUP - 3400 Spruce Street - Path Med Administration/ Quality Assurance ) **Responsibilities:** + **Technical Services:** Monitors pre-analytical, ... Science and other students. + **Regulatory Compliance** : Works with the Division's Quality Assurance manager in functioning as liaison to accrediting /… more
- CVS Health (Sacramento, CA)
- …GPS, HRP, PeopleSafe, PNC, OneKit Tool, Market Prominence, MARx, and other Medicare Systems. Experience with coaching process. Experience with building reporting and ... Qualifications Experience with grievance and/or CTMs. 2+ years in Medicare Experience analyzing and presenting data. Experience with call...call reviews EducationAA preferred ( or 2 years in Medicare equivalent) Pay Range The typical pay range for… more
- Commonwealth Care Alliance (Boston, MA)
- …experience and/or Call Center experience **Desired Experience:** + Experience with quality assurance , particularly in the healthcare field. + Experience ... Important to Us:** **Position Summary:** Reporting to the VP Quality & Controls Assurance , the incumbent is...will verify enrollment is entered correctly for Medicaid and Medicare effective dates. This position will also conduct reviews… more
- Cleveland Clinic (Mayfield Heights, OH)
- …resource for staff to facilitate overall operations of programs. + Develop meaningful quality assurance activities with clinical leadership to establish when a ... respected healthcare organizations in the world. The Safety and Quality Patient Experience Specialist II (SQPE) leads...regulations and standards of care. + Supports medical staff quality assurance activities such as peer review,… more
- Medical Mutual of Ohio (OH)
- …as a Business Systems Specialist or equivalent experience with software quality assurance and testing. . Project Management Certification preferred. . ... Systems Specialist or equivalent experience with software quality assurance and testing processing systems in...self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.… more
- MetroLink (Los Angeles, CA)
- …performing a variety of business processes and data entry associated with monitoring, quality assurance , and data integrity. + A combination of training, with ... Benefits + Questions SUMMARY PURPOSE OF POSITION The Contracts Specialist performs quality control checks, confirms that...exceeds $50,000, be added to your Federal, State, and Medicare taxable earnings for W-2 reporting. This amount is… more
- Centers for Independence (Fond Du Lac, WI)
- …Care Manager to provide quality initiatives by requiring adherence to quality assurance policies and procedures; assisting in developing new models; ... ** Quality Monitoring Specialist ** **Job Details** **Job...understanding of long-term care, disabilities, Medicaid, managed care and/or Medicare is preferred. + Maintains professional and technical knowledge… more
- Cleveland Clinic (Cleveland, OH)
- …resource for staff to facilitate overall operations of programs. + Develop meaningful quality assurance activities with clinical leadership to establish when a ... regulations and standards of care. + Supports medical staff quality assurance activities such as peer review,...in working with Joint Commission, HFAP, CMS (Centers for Medicare and Medicaid: Government agency that provides reimbursement for… more
- Kelsey-Seybold Clinic (Pearland, TX)
- …The Utilization Review Specialist (LVN) will support the Utilization Review quality assurance initiatives including mock audits to ensure compliance. The ... a liaison to the Grievance and Appeals Department for Medicare Advantage appeals. The Utilization Review Specialist ...as we continue to grow, our focus is providing quality patient care by adding to our team of… more
- Health First (Palm Bay, FL)
- …outstanding balances prior to service and post payments. 10. Maintain established quality assurance and productivity benchmarks while utilizing best practice ... *POSITION SUMMARY* To be fully engaged in providing exceptional Quality /No Harm, Customer Experience, and Stewardship to ensure the Mission/Vision and financial… more
- New York State Civil Service (Albany, NY)
- …Albany Street Address Division of Eligibility and Marketplace Integration / Bureau of System Quality Assurance 14 Corporate Woods City Albany State NY Zip Code ... HELP No Agency Health, Department of Title Medical Assistance Specialist 1 - 79640 Occupational Category Other Professional Careers...incumbents will work within the DEMI Bureau of System Quality Assurance . The Bureau conducts quality… more
- New York State Civil Service (Albany, NY)
- …Street Address Division of Eligibility and Marketplace Integration / Bureau of System Quality Assurance and Business Requirements 14 Corporate Woods City Albany ... within the Division of Eligibility and Marketplace Integration (DEMI), Bureau of System Quality Assurance & Business Requirements. The Bureau conducts quality… more
- City and County of San Francisco (San Francisco, CA)
- …methods, and procedures within the specialty area; including but not limited to Quality Assurance activities; prepares or reviews detailed and complex medical ... Public Health continuously accepts applications for all Senior Physician Specialist positions. + ✅Start with this Required Questionnaire https://forms.office.com/g/2a7KLdZBTz… more
- Aveanna (Houston, TX)
- … Specialist will report to the Director of Regulatory Compliance and Quality Review. The Regulatory Compliance and Coverage Specialist will complete detailed ... Regulatory Covg & Comp Specialist ApplyRefer a FriendBack Job Details Requisition #:...experience in healthcare compliance related activities (clinical record review, quality + assurance , performance improvement, auditing, or… more
- LA Care Health Plan (Los Angeles, CA)
- …providers, and clients to address discrepancies and ensure accurate billing and reimbursement. (15%) Quality Assurance - Conduct quality assurance checks ... Coordination of Benefits Validation Specialist II Job Category: Administrative, HR, Business Professionals...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- Evolent Health (Columbus, OH)
- …to ensure they meet the minimum standards for National Committee for Quality Assurance + Utilization Review Accreditation Commission (URAC), Employee Retirement ... + Knowledge of legislative/oversight bodies [e.g., National Committee for Quality Assurance Utilization Review Accreditation Commission (URAC), Employee… more
- Lancaster General Health (Lancaster, PA)
- …monthly nursing unit inspections, maintains workload records and collects quality assurance data. **JOB REQUIREMENTS** **MINIMUM REQUIRED QUALIFICATIONS:** ... **Summary** **Job Description** **Job Title: Clinical Pharmacy Specialist - Drug Information** **This position is located...information. + Conducts drug utilization reviews to assure the quality of drug use. Determines if criteria for drug… more