• Director , Quality Improvement

    Humana (Sterling Heights, MI)
    …of our caring community and help us put health first** The Quality Improvement Director provides strategic leadership for Humana's Michigan Medicaid Quality ... and serves as the local health plan lead for accreditation compliance. The Quality Improvement Director oversees all aspects of the plan's Quality Assurance and… more
    Humana (07/03/25)
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  • Senior Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …conjunction with the Director of PHM/ Medical Management and Quality Improvement Director . + Oversees and mentors Medical Directors and Physician Reviewers. ... programs and work plans. + Assists the Chief Medical Officer and the Quality Improvement Director in creating and maintaining a system that gives feedback to… more
    Sharp HealthCare (04/20/25)
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  • Medical Director , Clinical Review and Care…

    MVP Health Care (Schenectady, NY)
    …relevant regulatory/accreditation requirements (eg, CMS, NCQA, DOH) + Knowledge of quality improvement including HEDIS , STAR, CAHPS measures is preferred. + ... Medical Director , Clinical Review and Care Integrity 625 State...for everyone - which requires innovative thinking and continuous improvement . To achieve this, we're looking for a **Medical… more
    MVP Health Care (06/24/25)
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  • Medical Director - Sharp Health Plan…

    Sharp HealthCare (San Diego, CA)
    …and Chief Medical Officer and reports findings in conjunction with the Quality Improvement Manager. + Participates in the grievance process with the Chief ... in short and long range program planning, total quality management (quality improvement ), and external relationships. Works with all departments of Health Services… more
    Sharp HealthCare (05/18/25)
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  • Medical Director (CT)

    Molina Healthcare (WI)
    … activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
    Molina Healthcare (07/11/25)
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  • Medical Director , Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …is right for you, we encourage you to apply! Job Description: The Medical Director participates in the broad array of activities of the Medical Services area ... medical policies, guidelines and medical criteria. + Assists with training medical director colleagues and nursing staff , including leadership of teaching grand… more
    Excellus BlueCross BlueShield (07/01/25)
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  • Director , Government Programs Risk…

    Blue KC (Kansas City, MO)
    …that partners with multiple stakeholders and business unit leadershipto drive ongoing process improvement to ensure risk adjusted revenue optimization. + ... financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit assumes overall… more
    Blue KC (06/18/25)
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  • Physician - Amputee Medical Director

    Veterans Affairs, Veterans Health Administration (Augusta, GA)
    …of compliance with expected clinic operational and quality metrics (SAIL, HEDIS , etc. An integral member of the Interdisciplinary Polytrauma/TBI Team, ... necessary. Participates in selected committees. Participates in Service Quality Improvement /Performance Improvement , and Quality Management activities. Others… more
    Veterans Affairs, Veterans Health Administration (05/15/25)
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  • Senior Quality Performance Improvement

    Alameda Health System (Oakland, CA)
    …and cultivate a quality-supportive climate. 15. Utilize tools and techniques for process improvement to meet targets across multiple operational areas, including ... experience with progressive levels of responsibility preferred. Preferred Experience: Experience in process improvement models, eg Improvement Model, PDSA,… more
    Alameda Health System (07/11/25)
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  • Population Health Manager

    Apicha Community Health Center (New York, NY)
    …supporting improvement of patient health outcomes + Support implementation process and data optimization efforts to ensure data is accurate and reliable ... a multidisciplinary staff to meet Population Health and quality improvement goals through projects aligned with the mission of...and statements of work under the guidance of the Director of Population Health Management + Monitor project progress… more
    Apicha Community Health Center (05/22/25)
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