Healthcare Qa Manager Jobs in Pittsburgh

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 ..

Job Information Humana UM Medical Director - Conviva in Pittsburgh Pennsylvania Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex ..

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 ..

... in Pittsburgh Pennsylvania Description The Healthcare Quality Reporting & Improvement (HQRI) ... nationally. The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) ... guidance to ensure physician and..

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..

... Planning - Medical Communications – Healthcare Communications- Medical Affairs This is ... This position is responsible for QA/QC, directing/leading/mentoring a team in the ... Virology, HCV, Hepatitis C, R/A,..

About this job Find your commute UPMC Presbyterian is hiring a Medical Lab Scientist ( Medical Technologist) or Medical Lab Technician to support the Microbiology Lab! This role will work a ..

... & 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..

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 ..

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 ..

Coding Specialist We have exciting employment opportunities for remote HIM Coding Specialists on our Outsource Coding Team. Position Summary The HIM Coding Specialist will handle medical coding and data entry / ..

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 ..

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 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 ..

Job Information Humana Associate Director, Site Reliability Engineering in Pittsburgh Pennsylvania Description The Associate Director, Site Reliability Engineering maintains, integrates and implements software applications within the organization. The Associate Director, Site ..

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 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..

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). ..

... in Pittsburgh Pennsylvania Description The Healthcare Quality Reporting & Improvement (HQRI) ... guidance to ensure physician and healthcare provider plans, education, reporting and ... regional strategies for physician and..

... This position reports to the Manager of Risk Adjustment Coding. As ... Minimum Education: Associate degree in healthcare or equivalent work experience. Certified ... Accounting, Customer Service, Design Developer,..