Description : The Claims Quality Assurance serves as the claim technical expert for the Claims Operations by auditing... on these to senior leadership of assigned offices. Support the Claims Quality Assurance Program and the EC Operations team...
Description : CorVel is seeking a Quality Assurance Nurse. A person in this role is responsible for case management... quality assurance and mentorship to equip operations with tools and processes for consistent delivery of CorVel’s case...
of quality assurance Standard documentation and tracking processes Follow standard programming guidelines and requirements... and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the...
Responsibilities: Responsible for all aspects of quality assurance Standard documentation and tracking processes Follow standard... and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the...
Responsibilities: Claims related and business system analysis Responsible for all aspects of quality assurance Create and edit... health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access...
of managing relationships with clients and/or vendors 2+ years of managing budgets, process improvement and quality assurance... as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Claims...
, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual... system. Provide updates and insights on claims performance metrics to supervisors as needed Quality Integrate...
Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care... in testing and training for system updates, including enhancements in QNXT and other claims processing platforms. Quality...
, and Medicaid-specific requirements. Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed... and improve lives every day. Primary Purpose The Claims Overpayment Specialist is responsible for reviewing, investigating...
risk assessment, claims management, and quality improvement initiatives. The position requires a Registered Nurse... on quality improvement processes and initiatives Provide clinical expertise to support quality assurance programs Investigate...
guideline revisions b. Configuration and quality assurance of clinical criteria, decision scenarios, and other elements c... * Compare prescription claims data against requested parameters and summarize/present results or recommendations Prescription...
, and Quality Assurance. RESPONSIBILITIES & QUALIFICATIONS Essential Duties As a part of the Sunrise team, supporting... and email to Regional Business Manager by deadline. Quality Assurance & Safety Focus on Resident Centered Care and quality...
Management to design and manage an external quality assurance program to ensure compliance with best practices and promote... with and supports the Director, EHS and VP, Environment Health Safety and Quality and Corporate Worker Compensation Manager refining...
risk assessment, claims management, and quality improvement initiatives. The position requires a Registered Nurse... on quality improvement processes and initiatives Provide clinical expertise to support quality assurance programs Investigate...
, utilization review, managed care organization quality review, and quality assurance for programs serving individuals...Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe...
. Maintaining quality assurance through audits. Ability to create and present analysis reports. Analyze potential personal injury...'s services. The role demands an understanding of call center operations, specifically in law firm or insurance claims...
Office skills. Ability to learn new software programs. Knowledge of Texas Medicaid, National Committee for Quality Assurance... administration or related discipline required. Bachelor’s degree preferred. Experience Three years of QNXT or other claims...
, managed care organization quality review, and quality assurance for programs serving individuals with developmental... by a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery...
, managed care organization quality review, and quality assurance for programs serving individuals with developmental... by a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery...
. Maintaining quality assurance through audits. Ability to create and present analysis reports. Analyze potential personal injury...'s services. The role demands an understanding of call center operations, specifically in law firm or insurance claims...