• Manager , Clinical Quality

    Molina Healthcare (Augusta, GA)
    …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
    Molina Healthcare (04/25/25)
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  • Behavioral Health Case Manager

    Molina Healthcare (Edgefield, SC)
    **JOB DESCRIPTION** Behavioral Health Case Manager will work in remote and field setting supporting our Medicaid SMI (Severe Mental Illness) Population in the state ... of South Carolina. Case Manager will be required to communicate telephonically and complete...to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based… more
    Molina Healthcare (04/02/25)
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  • Regional Director, Quality Solutions…

    Molina Healthcare (Augusta, GA)
    …plan to achieve performance goals. + Direct management of QS HPP program manager . Coordination with health plan quality staff. Ensure organization with other ... years of experience in Managed Care and/or health plan quality . Clinical experience is needed for positions...for positions that are focused on Accreditation, Compliance, HEDIS Interventions , Potential Quality of Care issues, and… more
    Molina Healthcare (04/30/25)
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  • Case Manager (RN) (Must Reside in CA)

    Molina Healthcare (Augusta, GA)
    …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
    Molina Healthcare (04/11/25)
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  • Lead Overreader, HEDIS Abstraction…

    Molina Healthcare (Augusta, GA)
    …accuracy of abstracted records as required by specifications. + Assists the quality improvement staff with physician and member interventions and incentive ... **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits...off of the audit and chart review. + Assists Manager and Supervisor(s) in leading the training and mentoring… more
    Molina Healthcare (04/11/25)
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  • Master Social Worker - MSW

    Fresenius Medical Center (Newberry, SC)
    …patient education programs, established social work theory and methods, social work focused interventions , and quality of life measurement instruments as part of ... to patients as permitted within the scope of their clinical training and state license. + Provides educational and...including documentation. + Documents based on MSW interaction and interventions provided to patient and/or family. + Quality more
    Fresenius Medical Center (02/15/25)
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  • Social Worker

    HCA Healthcare (Augusta, GA)
    …and facilitates the timely implementation of discharge plans and arranges post-acute interventions identified in the plan of care. The SW facilitates patient ... + You will obtain input from the RN case manager to ensure the discharge plan is appropriate and...patient discharge plan as needed, in conjunction with the clinical team. + You will participate in the interdisciplinary… more
    HCA Healthcare (05/08/25)
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