• Director , Quality Improvement

    Health Care Service Corporation (Chicago, IL)
    …This position is responsible for managing and directing clinical quality improvement and population health oversight activities, driving continuous quality ... improvement consistent with HCSC goals, regulatory requirements, and accreditation. The senior director will remain current with best practices and innovations in… more
    Health Care Service Corporation (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Director , Quality Improvement

    Centene Corporation (Jefferson City, MO)
    …experience this area is highly preferred** **Position Purpose:** Lead and direct process improvement activities that provide more efficient and streamlined ... Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set ( HEDIS ) performance + Responsible for quality improvement aspects of… more
    Centene Corporation (12/11/25)
    - Save Job - Related Jobs - Block Source
  • Director Quality

    Providence (Portland, OR)
    …assess systemic and case-specific problems, and facilitate barrier analysis and process improvement . + **Vendor Management:** Oversee vendor contracts for ... strategist with a deep passion for healthcare quality and improvement ? Have you worked in a Health Plan specific...a prime opportunity for you! **The Role:** As the Director of Quality, you will be at the forefront… more
    Providence (12/04/25)
    - Save Job - Related Jobs - Block Source
  • Director of Operations Health DC Plan

    AmeriHealth Caritas (Washington, DC)
    …areas, other lines of business, and external vendors to identify opportunities for process improvement to drive compliance and efficiency. + Develops and ... developing, and implementing Health Plan activities related to the HEDIS process , improving HEDIS rates...and flexibility to a rapidly moving business environment. + Process improvement and project management experience. +… more
    AmeriHealth Caritas (10/28/25)
    - Save Job - Related Jobs - Block Source
  • Assistant Director QI

    State of Indiana (Indianapolis, IN)
    …mission. Role Overview: As Assistant Director , you will serve as the Director of Quality Improvement (QI), an integral component in serving Medicaid members. ... delivery. You will oversee managed care entities' (MCE) quality management and improvement functions, HEDIS data and scoring, NCQA Accreditation, Annual Quality… more
    State of Indiana (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Associate Director of Quality - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …Serve as operational support for quality initiatives, contributing to strategy, process design, implementation, and ongoing evaluation and improvement **Quality ... the status quo Within MSHP, the Quality Team drives the implementation and ongoing improvement of initiatives that enable Mount Sinai to deliver better value to its… more
    Mount Sinai Health System (11/20/25)
    - Save Job - Related Jobs - Block Source
  • Director Ambulatory Quality & Population…

    UNC Health Care (Morrisville, NC)
    **Description** ** Director of Ambulatory Quality and Population Health Analytics** Become part of an inclusive organization with over 40,000 teammates whose mission ... health and well-being of the unique communities we serve. **Summary** The Director of Ambulatory Quality and Population Health Analytics leads analytics business… more
    UNC Health Care (11/18/25)
    - Save Job - Related Jobs - Block Source
  • 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 (09/30/25)
    - Save Job - Related Jobs - Block Source
  • Sr. Director , Client Analytics

    Evolent (Lincoln, NE)
    …of our specialty programs and administrative platform. **Role Overview** The Senior Director role on Client Analytics will lead the development and execution of ... ensuring compliance with applicable guidelines. + Lead the design, development, improvement , and maintenance of BI dashboards and reports that provide actionable… more
    Evolent (11/25/25)
    - Save Job - Related Jobs - Block Source
  • RN Quality Improvement Specialist - Health…

    Aspirus Ironwood Hospital (Wausau, WI)
    …the Director of Operations to develop and implement a cohesive Quality Improvement Program that supports NCQA, HEDIS and Medicare Star Ratings. HOURS: Full ... Plan in Wausau, WI is seeking a RN QUALITY IMPROVEMENT SPECIALIST to join our ASPIRUS HEALTH PLAN team... Program (QIP) is the framework for a formal process to assess and monitor our performance through a… more
    Aspirus Ironwood Hospital (12/13/25)
    - Save Job - Related Jobs - Block Source
  • Health Plans Licensed Practical Nurse LPN Auditor

    Banner Health (AZ)
    …evaluate data, and write reports; to implement and track the effectiveness of process improvement ; to recognize risk management concerns; and to review and ... established AHCCCS standards for documentation in conjunction with the re-credentialing process . 3. Monitors and tracks Corrective Active Plans (CAPs), in… more
    Banner Health (11/27/25)
    - Save Job - Related Jobs - Block Source
  • RN Case Manager - Value Based Service Org - Full…

    University of Southern California (Alhambra, CA)
    …clinical and social work experience to ring an understanding of the clinical process of assessment, planning, implementation, and evaluation to the process of ... case management plan; and Educating the patient/family/caregiver about the case management process and evaluating their understanding of the process . Some of… more
    University of Southern California (11/19/25)
    - Save Job - Related Jobs - Block Source
  • Sr Mgr,MC Clinical SPM R22

    CVS Health (Richmond, VA)
    …operational, programs and/or system enhancements and is a key player in leading process improvement in these areas Evaluate and assess inputs regarding clinical ... a week. This leadership role reports to the Area Director (AD) and leads a team of NPs, PAs,...Develop intervention strategies and assess outcomes consistent with continuous process improvement Manage fiscal responsibilities to budget… more
    CVS Health (11/26/25)
    - Save Job - Related Jobs - Block Source
  • Manager, Case Management (Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …employee performance reviews, and staffing patterns, identifying areas needing improvement and initiates appropriate action including productivity monitoring and ... and prepares reports as necessary, including those related to Quality Improvement Plan activities. Provides presentations as they relate to specific functions… more
    Excellus BlueCross BlueShield (12/03/25)
    - Save Job - Related Jobs - Block Source
  • Utilization Review RN

    Community Health Systems (Naples, FL)
    …standard work, and policy/procedure development. + Partners with internal departments to promote process improvement and compliance with UR standards and KPIs. + ... who needs a reasonable accommodation for any part of the application or hiring process , contact the director of Human Resources at the facility to which… more
    Community Health Systems (11/20/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager, Maternity (RN or LMSW)

    Excellus BlueCross BlueShield (Rochester, NY)
    …Accountabilities) + Handles all member clinical condition management programs. + Offers process improvement suggestions and participates in the solutions of more ... procedures per corporate and departmental policy. + Implements the Case Management Process per department policies, procedures and guidelines. The process more
    Excellus BlueCross BlueShield (11/26/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager - Registered Dietician

    CDPHP (Latham, NY)
    …clinical condition management programs, within clinical area of expertise.[JW3] + Offers process improvement suggestions and participates in the solutions of ... procedures per corporate and departmental policy. + Implements the Case Management Process per department policies, procedures and guidelines. The process more
    CDPHP (11/25/25)
    - Save Job - Related Jobs - Block Source
  • Clinical Quality Assurance Specialist- SF Center-…

    Good Samaritan (Sioux Falls, SD)
    …the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues and adverse events ... Will complete chart reviews, documentation of findings, referral for medical director review and required reporting. Will perform healthcare effectiveness data and… more
    Good Samaritan (10/18/25)
    - Save Job - Related Jobs - Block Source
  • Staff Physician - Primary Care (Kenosha CBOC)

    Veterans Affairs, Veterans Health Administration (Kenosha, WI)
    …or for McHenry CBOC, the s/he has delegated authority from the Clinical Director for Primary Care (DPC) with responsibility for their respective clinic(s), and in ... congressional inquiries, staff complaints or conflict, interdepartmental conflict, and process issues. - Responsible for innovative methods to optimize collaboration… more
    Veterans Affairs, Veterans Health Administration (10/16/25)
    - Save Job - Related Jobs - Block Source
  • Patient Services Representative

    Making Opportunity Count Inc (Fitchburg, MA)
    …Healthcare Pay Range: $20.43 to $27.64 per hour Reports To: Senior Director of Health Program Operations Supervisory Responsibilities: No Revision Date: 11/27/2024 ... appointments as indicated by the provider, checking for duplicates + Process referrals, diagnostic, and lab orders, ensuring specialist offices receive relevant… more
    Making Opportunity Count Inc (12/12/25)
    - Save Job - Related Jobs - Block Source