- US Tech Solutions (South San Francisco, CA)
- …performance reviews with Team Leads and Team Managers. + Conducted quality assurance activities, including monitoring staff communications and productivity. ... Team Performance Consultant will be responsible for revising, managing and coordinating quality oversight and performance review process for members of the Team.… more
- Centene Corporation (Columbia, SC)
- …+ Serves on the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and accuracy of ICD-9/ICD-10 coding) ... risk adjustment to ensure accurate CMS payment and improve quality of care . Analysis of MRA data...experience in a hospital, a physician setting or a Managed Care Organization as a medical coder… more
- Centene Corporation (NV)
- …+ Serves on the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and accuracy of ICD-9/ICD-10 coding) ... risk adjustment to ensure accurate CMS payment and improve quality of care . Analysis of MRA data...experience in a hospital, a physician setting or a Managed Care Organization as a medical coder.… more
- Centene Corporation (Yuma, AZ)
- …+ Serves on the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and accuracy of ICD-9/ICD-10 coding) ... risk adjustment to ensure accurate CMS payment and improve quality of care . Analysis of MRA data...experience in a hospital, a physician setting, or a Managed Care Organization as a medical coder… more
- InnovaCare (San Juan, PR)
- …concurrently review admissions and continued stay to determine appropriate Utilization, Quality Assurance , Risk Management and Discharge Planning Needs.2. ... the most advanced technologies. Innovacare, Inc. combines innovation and quality care to create progressive, value-based models,...team, with its vast years of combined experience in managed care and care delivery,… more
- Molina Healthcare (Dallas, TX)
- …field. **Required Experience** + Minimum two years UM, CM, MAT, HM, DM, and/or managed care experience. + Proficient knowledge of Molina workflows. + Required ... 3-5 years of experience in case management, disease management or utilization management in managed care , medical or behavioral health settings. + Two years of… more
- Parsons Corporation (Fort Belvoir, VA)
- …dirty word lists, unauthorized domains, and behavior not compliant with the AOO/client managed attribution Terms of Use (TOU) and AR 381-10 or other client-based ... for action in the case of potential Questionable Activities ( QA ) or TOU violations. + Review material for potential...value our employees and want our employees to take care of their overall wellbeing, which is why we… more
- Abbott (Alameda, CA)
- …an equivalent combination of education and work experience + Minimum 6 years of Quality Assurance experience in the medical device, pharmaceutical or other ... quality managed industries **Preferred Qualifications** + Some...and statistical techniques. + Some experience in conducting external quality assessments. + Certified Lead Auditor trained… more
- Weatherford (Houston, TX)
- …experience in quality related capacity. + Strong knowledge of project management, quality assurance and quality control processes and philosophies. + ... & protection of the Environment, taking into account responsible care , process vulnerabilities, public, customer and employee inputs, knowledge...or process adherence. + As requested by the GZ Quality Manager and Auditor , provide PL SME… more
- Parsons Corporation (Harrisburg, PA)
- …for reviewing and approving audit reports generated by our team of Quality Assurance auditors for compliance, accuracy, and client expectations Ensures ... in the automotive field. If you are self-motivated and self- managed , this is a great opportunity! Essential job tasks:...company safety and quality assurance policies by evaluating and maintaining… more
- LA Care Health Plan (Los Angeles, CA)
- …Federal regulatory agencies; regulatory reporting; including design and implementation of quality assurance strategies to ensure reports submitted to regulators ... all regulatory reports and internal compliance reports. Designs and implements report quality assurance processes to ensure timely, complete, and accurate… more
- State of Colorado (Denver, CO)
- …on escalated claim and Prior Authorization (PAR) concerns. * Provide oversight of Quality Assurance protocols to review provider calls and case manager outreach ... Type Full Time Job Number UHA01923 06/05/2024 Department Department of Health Care Policy and Financing Division Community Living Office Opening Date 06/17/2024… more
- CVS Health (Topeka, KS)
- …social work, quality improvement or health coaching, preferably in a managed care environment + 2 years provider facing activities/value based ... Better Health (ABH) and its providers to facilitate high quality care for members. The Quality...responsible for providing education related to National Committee for Quality Assurance (NCQA) HEDIS measures, medical record… more
- Leonardo DRS, Inc. (Melbourne, FL)
- …management and combat vehicle integration products and services. **Job Summary** This Software Quality Assurance (SQA) Engineer will provide software quality ... team members. + Demonstrated leadership accomplishments professionally and personally. + Quality Auditor experience in technologies and application domain. +… more
- Sutter Health (San Francisco, CA)
- …for efficient final DRG assignment + In conjunction with the CDI Educator / Quality Auditor , utilizes commonly encountered SLR request subject matter, along with ... points to correct incomplete codes required to capture the quality of care and resource consumption. The...not limited to APR-DRG, MS-DRG, HCCs, Medicare, Medicaid & Managed Care , in order to design and… more