• Clinical Compliance

    Highmark Health (Raleigh, NC)
    …Description :** **JOB SUMMARY** This job is responsible for working with HHO clinical departments in the areas of compliance and process improvement. Serves ... as a corporate resource regarding accreditation standards, clinical performance and continuous improvement...maintenance of Care Management policies and procedures to ensure accreditation and compliance with NCQA and DMMA… more
    Highmark Health (06/28/25)
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  • RN Quality Project Coordinator

    Granville Medical Center (Oxford, NC)
    …planning and coordination of quality improvement initiatives, all while ensuring compliance with regulatory and accreditation requirements. This individual will ... RN Quality Project Coordinator Location: Granville Health System, Oxford, NC About...policy and protocol implementations, and a liaison to the clinical management team. With direction of the Director and… more
    Granville Medical Center (06/24/25)
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  • Case Manager, Registered Nurse - Oncology, Medical…

    CVS Health (Raleigh, NC)
    …clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits. + Applies clinical judgment to the incorporation of strategies designed to reduce risk… more
    CVS Health (07/08/25)
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