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Clinical Quality Compliance Lead
A company is looking for a Clinical Quality Compliance Lead to provide guidance on inspection readiness and compliance in clinical trials. Key Responsibilities Provide just-in-time guidance to study teams on operating model processes and documentation for inspection readiness Manage inspection
Senior Quality Improvement Analyst
A company is looking for a Quality Improvement Analyst Sr to support health system-wide quality and operational analytics. Key Responsibilities Collaborate on multi-disciplinary teams to provide analytical support for quality improvement projects Design, develop, and automate clinical quality and
Clinical Quality RN, HEDIS
A company is looking for a Clinical Quality RN, Hedis - Remote. Key Responsibilities: Review and abstract medical record data into appropriate systems Perform quality medical record reviews and assist in the improvement of clinical documentation processes Analyze chart data for integrity and
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Healthcare Compliance Manager
A company is looking for a Compliance Manager. Key Responsibilities Facilitate risk assessment, monitoring, and auditing activities to identify vulnerabilities and non-compliance Stay updated on healthcare laws and regulations, analyzing their impact on operations and informing
Compliance Training Specialist
A company is looking for a Compliance Training & Contracts Specialist (REMOTE). Key Responsibilities Oversee the delivery of compliance training for new hires and annual employee training Manage a Compliance Committee to maintain accurate compliance training materials Handle all contracts,
California Licensed Senior Quality Improvement Nurse
A company is looking Company a Senior Quality Improvement Nurse (RN) - Facility Site Review. Key Responsibilities Develops and manages healthcare strategies to improve member Company outcomes in line with DHCS standards Collaborates with teams to evaluate and report on provider performance
Licensed DRG Validation RN Auditor
A company is looking for a Remote DRG Validation RN Certified Auditor. Key Responsibilities Determine appropriate coding based on benefit plans Review coding designated as correct by peers Work hours between 7am to 6pm EST Required Qualifications CCS/CIC certification or will obtain within 6
Claims Quality Audit Representative
A company is looking for a Claims Quality and Audit Representative. Key Responsibilities Validate and analyze claim data for accuracy using various resources Deliver objective quality review determinations and provide supporting documentation for audits Maintain tracking of daily tasks and
Quality Assurance Manager
A company is looking for a Quality Assurance Manager. Key Responsibilities Manage and mentor a team of QA analysts, providing guidance and conducting performance reviews Design and improve QA processes, develop test strategies, and maintain quality reporting mechanisms Lead manual and automated
Billing and Coding Auditor
A company is looking for a Billing and Coding Auditor to ensure the accuracy and compliance of billing practices in behavioral health services. Key Responsibilities Conduct regular audits of behavioral health billing and claims for accuracy and compliance Review coding of services to ensure
