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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choo...

Job Description:
* Responsible for the review and evaluation of clinical information and documentation.
* Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
* Independently coordinates the clinical resolution ...

DEPARTMENT OF ECONOMIC SECURITY
Your Partner For A Stronger Arizona.
DES works with families, community organizations, advocates and state and federal partners to realize our collective vision: A thriving Arizona.
DES serves more than 3 million Arizonans. Our Mission is to strengthen individuals, families, and communities for a better quality of life.
QUALITY ASSURANCE INVESTIGA...

Join PACS: Elevate Healthcare with Us!
PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment , we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to en...

Join PACS: Elevate Healthcare with Us!
PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment , we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to en...

Hims & Hers is the leading health and wellness platform, on a mission to help the world feel great through the power of better health. We are redefining healthcare by putting the customer first and delivering access to care that is affordable, accessible, and personal, from diagnosis to treatment to delivery. No two people are the same, so we provide access to personalized care designed for res...

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choo...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career deve...

Overview
Are you looking for a place where you can make a genuine difference in our patient’s lives?
With over 20 locations and growing, Bridge Home Health & Hospice’s culture of love for our patients and employees is the top priority. Our commitment to our Core Values allows us to be the provider and employer of choice. We embrace a diverse workforce and understand that our employees are key...

Valor Healthcare is looking for a Quality Assurance program manager to join our proposal team for a government contract to support the Global Nurse Advice Line (NAL) which is a service to Military Health System (MHS) eligible beneficiaries.
Position Summary
The Global NAL will provide access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 2...

Job Description
Job Description
JOB SUMMARY:
The Senior Specialist, Quality Program Management & Performance RNensures quality monitoring audits and investigations are performed in accordance with prescribed quality standards. Informs data collection, reporting, and analysis to monitor key quality management activity and provides direction and implementation of federal/state quality management ...

JOB DESCRIPTION
Job Summary
Responsible for continuous quality improvements within the Delegation Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA, CMS and State Medicaid requirements including delegation standards and requirements contained in the delegation agreement.
KNOWLEDGE/SKILLS/ABILITIES
The Delegation Oversight Nurse is responsible for e...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Quality and HEDIS data analysis and reporting experience preferred.
Position Purpose: Plans, organizes, a...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Essential Functions: * Under general guidance form Senior Quality Practice Advisors and management, educate...

Job Introduction
Maximus is currently hiring for Sr. Regional Nurse Managers to support the New York Independent Assessor Program (NYIA). The NYIA Program serves the State of New York by conducting UAS assessments to determine eligibility for community-based long-term services. The Sr. Regional Nurse Manager will have the opportunity to lead and support a team of Nurse Managers who are on the...

Assistant Nurse Manager, OR
Onsite
12p-8:30p Mon, Tue, Wed, Thu, Fri *Administrative call rotated every 8 weeks. Monday thru Friday
San Jose, CA
Manages activities of the unit(s), monitors quality, service and utilization standards. Supervises the day to day shift activities.
Essential Responsibilities:
* Manages the units day to day clinical operations including practice st...

About RPM
Roman Pennsylvania Medical, P.C. (RPM) is a telehealth practice dedicated to providing high-quality, patient-centric care. RPM is part of the provider network affiliated with Ro, a direct-to-patient healthcare company. Providers help patients seeking care through Ro’s platform for their mental health, women’s health, men’s health, fertility, metabolic health, and skincare needs.
RPM...

Job Introduction
Maximus is currently seeking Quality Assurance Clinical Analysts to support the Independent Practitioner Panel (IPP) Program, which completes assessment reviews and issues practitioner orders for New Yorkers who qualify for long-term in-home care. The QA Clinical Analyst is responsible for reviewing assessments to ensure accuracy and consistency and collaborating with other pr...

Valor Healthcare is looking for a senior program manager to join our proposal team for a government contract to support the Global Nurse Advice Line (NAL) which is a service to Military Health System (MHS) eligible beneficiaries.
Position Summary
The Global NAL will provide access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 24 hours a ...

Heartbeat Health is a venture-backed health tech startup revolutionizing the delivery of cardiovascular care. Our vision is a world where cardiac conditions are detected early, care coordination is friction-free, and at-risk individuals are empowered to live long, heart-healthy lives. Powered by a connected ecosystem of heart health providers, Heartbeat delivers a range of clinical services, in...