Healthcare Qa Manager Jobs in Pennsylvania

Description The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or ..

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

Description The Vendor Quality Medical Director will manage clinical vendor quality outcomes for Humana Clinical Operations Team. Responsibilities A full time Medical Director to manage clinical vendor quality outcomes for Humana ..

... Kindred at Home RN Clinical Manager Home Health Full Time in ... in Lancaster Pennsylvania The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the..

Job Description Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on ..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

Job Information Humana Bilingual Quality Auditor in Pittsburgh Pennsylvania Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Review ..

Director of Quality - Lancaster PA - MAX $110,000 Note: Applicant must be resident of the USA or Green Card Holder. Must-Haves Clinical license required BSN or BS/BA required Demonstrated ability ..

... & Risk Management Quality Audit (QA) Risk Management Professional 2-Remote, US ... & Risk Management Quality Audit (QA) Risk Management Professional 2, you ... for executing the Compliance Oversight..

Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) in Pittsburgh Pennsylvania Description Humana Healthy Horizons is seeking a Quality Improvement Program Lead who will be responsible for the end ..

Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Nursing works within ..

... Kindred at Home RN Clinical Manager in Wilkes Barre Pennsylvania The ... Wilkes Barre Pennsylvania The Clinical Manager coordinates and oversees all direct ... documentation requirements. Responsible for the..

Description The Manager, Software Engineering codes software applications ... based on business requirements. The Manager, Software Engineering works within specific ... schedules and goals. Responsibilities The Manager, Software Engineering standardizes..

Job Description : JOB SUMMARY This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities ..

Job Description Summary: Health is everything. At CVS Health, colleagues are committed to increasing access, lowering costs and improving quality of care. Millions of times a day, we help people on ..

Job Information Humana Senior Quality Program Delivery Professional (Medicaid) - Remote, US in Pittsburgh Pennsylvania Description Humana Healthy Horizons is seeking a Senior Quality Program Delivery Professional who will manage and ..

Description The Manager, Compliance Nursing reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Manager, Compliance ..

Job Information DaVita Manager, Clinical Services in Malvern Pennsylvania ... a great fit for [insert manager role] with DaVita. Here's what ... expect as a Clinical Services Manager at DaVita:..

Job Information Humana Technical Product Manager - Remote in Pittsburgh Pennsylvania ... Senior Product Management Professional/Technical Product Manager (TPM) must be able to ... product backlog. The technical product manager..

Do you want to be part of an inclusive team that works to develop innovative therapies for patients? Every day, we are driven to develop and deliver innovative and effective new ..

Description The Manager, Risk Adjustment oversees coding educators and quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS). ..