- Molina Healthcare (Savannah, GA)
- …delivering on NCQA accreditation requirements. Plans and directs schedules, reporting, process improvement , and implores continuous quality improvement . ... : + 3-5 years of Program and/or Project management experience. + Operational Process Improvement experience. + Healthcare experience. + Experience with Microsoft… more
- Penn Medicine (Lancaster, PA)
- …the behaviorally mentally challenged, and minor patients. + Facilitates quality improvement activities directed at process outcomes and clinical practice ... Nursing. As a self-directed and empowered clinician, the CNS applies the nursing process to diagnose and treat illness, promote health, and influence change within… more
- Help at Home (Brooklyn, NY)
- …MLTC quality measures (eg, UAS-NY). + Minimum of three (3) years of quality/ process improvement experience. + Advanced skills in Microsoft Office, EMR/EHR ... execution of nurse visit schedules, including urgent and high-risk cases. + Lead efforts in continuous improvement , incorporating best practices, data analytics,… more
- General Dynamics Information Technology (Fairfax, VA)
- …as a **Salesforce Enterprise Manager** supporting the Centers for Medicare and Medicaid Services (CMS) Federal Services System Support and Oversight (FSSSO) program. ... Our work depends on **Salesforce Enterprise Manager** with a **C** **onsultant Mindset** to lead the evolution of our Salesforce platform. You will act as the bridge… more
- Houston Methodist (Katy, TX)
- …and accreditation/regulatory/ government regulations. + **Audit Oversight & Lifecycle Management** + Lead the management and response process for a variety of ... with CMS, commercial payer, and regulatory requirements. + Support policy and process development to strengthen audit readiness and response. + Participate in… more
- Intermountain Health (South Jordan, UT)
- …verifies medical necessity, and maintains clear communication throughout the order process . The coordinator manages patient orders from start to finish, including ... external relationships, and demonstrates problem-solving and compliance knowledge, including Medicare/ Medicaid billing and privacy regulations. + Audits casework and… more
- Commonwealth Care Alliance (Boston, MA)
- …* Maintain up-to-date knowledge of and compliance with CMS, NCQA and state Medicaid requirements. * Lead preparation for internal and external audits (eg ... teams to support care coordination and integrated care. * Manages the process for escalated reviews in accordance with Standard Operating Procedures. * Provides… more
- Humana (Nashville, TN)
- …to, PowerBI, Alteryx, Tableau, SQL, R & Python + Six Sigma Black Belt, Process Improvement and/or Quality Control expertise + Familiarity with Generative AI and ... Internal Audit. The Director Internal Audit will develop and lead risk based operational audits and consulting projects to...progressive thinking with a keen eye for improving business process and risk management and must be agile and… more
- MyFlorida (Fort Lauderdale, FL)
- …address identified concerns, collaborating with external stakeholders including the Quality Improvement Organization (QIO), Medicaid Program Integrity (MPI) and ... team members who demonstrate the qualities of being humble, hungry, and smart and lead others to embody the same. This entails lacking excessive ego, sharing credit,… more
- Boehringer Ingelheim (Ridgefield, CT)
- …department communication and projects. + Lead team toward continuous improvement and/or process design through analysis of existing processes. Facilitate ... the identification and implementation of process and procedures geared towards improving efficiency and productivity within the group. + Partner with the BIPI… more