Healthcare Quality Jobs in Concord

... Medical Center Location Details: Carolinas HealthCare System is Atrium Health. Our ... *Collects data pertinent to the healthcare consumer's health or the situation. ... a plan individualized to the..

Director, Contracting & Network Development','1199846','!*!Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.Oversee provider contracting activities ..

Description Humana's National Medicaid Quality team is seeking a Market ... for supporting individual Medicaid market quality teams and serving as the ... the corporate level National Medicaid Quality team..

Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Job ID 21000HOLAvailable Openings 1 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 21000I18Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

... moderate to substantial. Responsibilities The Quality Technology Leader collaborates with business ... to ensure the maturity of quality in the delivery of technology ... experienced with testing principles and..

... so that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of healthcare experience within a fraud investigations ... well as solid knowledge..

Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..

... the development and implementation of quality improvement interventions and audits and ... years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral ... degree Advanced degree in a..

Description The Vendor Quality Medical Director will manage clinical ... Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Director to manage clinical vendor quality outcomes for..

Job ID 21000E1GAvailable Openings 1 PURPOSE AND SCOPE: Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for assigned patients in accordance with FMCNA ..

... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..

Description The Informaticist 2 coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights from knowledge SMEs. The Informaticist 2 work assignments are ..

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..

Job ID 21000H89Available Openings 1PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. ..

Description The Senior Medicaid Quality Data and Reporting Analyst generates ... factors. Responsibilities The Senior Medicaid Quality Data and Reporting Analyst will ... the management and manipulation of quality data..

Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..