• NCQA Quality and Accreditation Specialist

    Integra Partners (Troy, MI)
    …UM and Credentialing leadership. + Educate and support UM and Credentialing staff on accreditation requirements, audit expectations, and quality standards. + ... maintaining accreditation activities for the Utilization Management (UM) and Credentialing departments. This includes supporting NCQA accreditation, implementing quality… more
    Integra Partners (12/02/25)
    - Related Jobs
  • Health Plans Licensed Practical Nurse LPN Auditor

    Banner Health (AZ)
    …and Information Systems, creates datasets for review by the Quality and Medical Management Administration Staff and other department studies as assigned, ... and extend our innovation to employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse...will be an integral part of the **Health Plan Medical Management Team** . This assignment-based role focuses on… more
    Banner Health (11/27/25)
    - Related Jobs
  • Medical Assistant Oncology

    Banner Health (Gilbert, AZ)
    …care. POSITION SUMMARY This position is responsible for assisting clinicians and nursing staff in providing medical care, as well as, implementing and evaluating ... through the cancer journey with patients, supporting their unique medical and personal needs every step of the way....to achieve Magnet (TM) recognition by the American Nurses Credentialing Center. Located near Phoenix in Gilbert, Ariz., Banner… more
    Banner Health (12/22/25)
    - Related Jobs
  • Medical Director, Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …assists the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit. ... flexible hybrid/ remote role! Essential Accountabilities: Level I + Provides medical leadership of all for utilization management, cost containment, and … more
    Excellus BlueCross BlueShield (11/12/25)
    - Related Jobs
  • Graduate Medical Education Coordinator,…

    Virtua Health (Evesham, NJ)
    …Review. Provide and authorized specialized review of internal and external rotational credentialing processes, with use of HR and Medical Affairs database, ... If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than… more
    Virtua Health (11/04/25)
    - Related Jobs
  • Occupational Medicine Physician - Reviewing…

    STG International (Rockville, MD)
    medical records securely according to TJC standards . + Maintains appointment to medical staff and privileges for all services assigned according to FOH ... Remote . Job Specific Duties and Responsibilities: The Reviewing Medical Officer (RMO) in the Law Enforcement and Surveillance...Credentialing and Privileging policy . + Maintain board-certification and… more
    STG International (12/19/25)
    - Related Jobs
  • Occupational Medicine Physician - Reviewing…

    STG International (Rockville, MD)
    medical records securely according to TJC standards . + Maintains appointment to medical staff and privileges for all services assigned according to FOH ... Federal Occupational Health Services (FOH) in Rockville, MD and/or Nationwide/ Remote . The Reviewing Medical Officer (RMO) in...Credentialing and Privileging policy . + Maintain s board-certification… more
    STG International (12/19/25)
    - Related Jobs
  • Medical Director - Pharmacy Appeals

    Humana (Lincoln, NE)
    … necessity. The Medical Director will collaborate with clinicians and support staff to provide Humana members with optimal value based care in accordance with ... a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D… more
    Humana (12/03/25)
    - Related Jobs
  • Clinical Specialist, Ventilation

    ZOLL Medical Corporation (Houston, TX)
    …manage client in-service and training programs; provide product and service education to staff at hospitals and other medical facilities to facilitate technology ... innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and… more
    ZOLL Medical Corporation (11/19/25)
    - Related Jobs
  • Medical Director

    NYU Rory Meyers College of Nursing (New York, NY)
    …Director serves as the lead physician for the SHC in matters of accreditation, credentialing , and licensing. They are responsible for staff in departments that ... protected basis. All interested persons are encouraged to apply at all levels. The Medical Director of the NYU Student Health Center will play a pivotal role in… more
    NYU Rory Meyers College of Nursing (10/24/25)
    - Related Jobs