Healthcare Improvement Jobs in Charleston

Description The Senior Quality Improvement Professional will focus organizational efforts ... Director, Behavioral Health Director, Quality Improvement Manager and those targeting specialized ... an organization-wide culture of quality improvement. Senior..

Job ID 21000FMNAvailable Openings 2 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered Nurses. The CAP ..

Job ID 21000HVGAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of ..

Description Humana is seeking an experienced and dynamic Associate Director of Accreditation to manage a team of subject matter experts on NCQA Health Plan Accreditation and NCQA Health Equity Accreditation. The ..

Description The Senior Pre-Authorization Nurse reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. Makes decisions on ..

Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..

Description Humana Medicaid is growing and you have the unique opportunity to grow with us! Join our team and propel Humana forward to solve the technology challenges of tomorrow. You'll collaborate ..

Genesis HealthCare is one of the nation's ... the nation's leading providers of healthcare services from short-term to long-term ... through the delivery of high-quality healthcare and everyday compassion!We Care..

Description The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding for services rendered is complete, compliant and accurate to support optimal reimbursement. Responsibilities ..

Job Information Humana Quality Improvement Program Lead (National Medicaid Quality) ... Horizons is seeking a Quality Improvement Program Lead who will be ... Humana Healthy Horizon's National Quality Improvement (QI)..

Description The Health Information Management Professional ensures data integrity for claims errors. The Health Information Management Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate ..

Description The Data and Reporting Professional II generates ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. The ..

... Florida is seeking a STARS Improvement Professional 2 who will develop, ... They will direct all quality improvement programs and initiatives. The STARS ... programs and initiatives. The STARS..

Genesis is one of the nations' leading provider of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are changing how ..

Genesis a leading provider of healthcare services from short-term to long-term ... department.Foster an environment of continuous improvement and mentor staff to achieve ... in employing a strong Quality Improvement..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The Process Improvement Lead analyzes, and measures the ... business process improvements. The Process Improvement Lead works on problems of ... lead a team of process improvement professionals supporting..

Job Information Humana Senior Innovation Portfolio Strategy Professional in Charleston West Virginia Description The Humana Healthy Horizons Strategic Solutions team's purpose is to accelerate the ideation and development of transformational initiatives ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..

Description The Remote Systems Clinical Pharmacist will provide excellent customer service to both internal and external customers by developing and maintaining relationships with Account / Clinical Management and PCO-IPU Operations teams. ..

... Information Humana RN, Senior Stars Improvement, Clinical Professional in Charleston West ... seeking a RN, Senior Stars Improvement, Clinical Professional who will be ... Stars Program. The Senior Stars..

Job Information Humana Quality Improvement Coordinator in Charleston West Virginia ... West Virginia Description The Quality Improvement Coordinator 3 assists in administering ... in administering and monitoring quality improvement and..