- The Cigna Group (Franklin, TN)
- …adjudication platform, maintenance and implementation required. + Experience in Business Quality Assurance processes, required. + Commitment to expand knowledge ... day-to-day operations with ultimate responsibility for the successful completion and quality of claims systems deliverables. This position will perform duties under… more
- Sharp HealthCare (San Diego, CA)
- …clinical background and skills. + Solid understanding of utilization management and quality assurance activities and concepts. + Excellent communication skills, ... leadership and direction to the utilization/cost management and clinical quality management functions. Works collaboratively with other plan functions that… more
- Northwell Health (New Hyde Park, NY)
- …enrollment, and onboarding of new providers. + Validates integrity and performs Quality Assurance of provider demographic, billing, plan participation and other ... Impact Assessments (PIAs) for large-scale data initiatives. + Experience with Data Quality checks with ETLs/ELTs and also with the Data Governance platform… more
- CareFirst (Baltimore, MD)
- …Support the efforts of the Mandates and ePMO team in the creation, quality assurance and refinement of Project Documentation and Status Reporting. **SUPERVISORY ... RESPONSIBILITY:** Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** Bachelor's Degree in Business, Finance or… more
- TEKsystems (Salt Lake City, UT)
- …and operations. This includes active participation and coordination with the Development, Quality Assurance , and functional teams to ensure seamless updates, ... releases, and new feature implementations. Develop thorough and positive communication, both specific and broad, for system changes being implemented in production. 20% * Responsible for maintaining effective and efficient information technology systems and… more
- Stanford Health Care (Palo Alto, CA)
- …+ Conduct regular unit staff meetings; + Conduct and report on monthly productivity/ quality assurance audits. + Encourage ongoing staff development and growth. ... performance. + Manage implementation of standards and systems to enhance quality , consistency, efficiency, and timeliness of responsibilities for the enterprise;… more
- CareFirst (Baltimore, MD)
- …MedInsights) and other related functions. + Ensure data integrity by implementing quality assurance practices. + Implement data strategies and manage projects ... and data improvements. Ensure compliance with deliverable reporting requirements by performing quality data audits and analysis. + Oversee the creation and delivery… more
- Bowman (Paonia, CO)
- …application of sound professional judgement. Review work produced by junior staff for quality assurance . **At the Operational and Company Level** + Assist with ... and written communication skills. + Strong work ethic and commitment to quality . + Self-reliance and ability to operate independently with limited direction. +… more
- CareFirst (Baltimore, MD)
- …performance; identifying and resolving operations problems; supervising process improvement and quality assurance programs; installing upgrades. + Prepares call ... training and development, policies, procedures, and work production quantity and quality . Functional areas may include but not limited to: installation,… more
- Sharp HealthCare (San Diego, CA)
- …plans related to health plan audits and requirements of National Committee on Quality Assurance (NCQA) and other governing regulatory bodies. Collaborates with ... the Quality , Compliance, and Training Department to effectively integrate and...setting. **Other Qualification Requirements** + Utilization, Case Management, or Quality Management certification preferred. **Essential Functions** + Ambulatory Case… more