Senior Clinical Quality RN: Medicaid/Medicare Oversight
ISHE
UnitedHealthcare seeks a Senior Clinical Quality of Care RN to conduct QOC investigations and manage regulatory IAD processes for Arizona Medicaid/Medicare members. The role is Arizona-based with remote work and up to 40% in-office, plus up to 25% travel, located at 1 East Washington Street, Phoenix. Collaboration with Medical Directors ensures regulatory compliance and timely deliverables. Requirements include an Arizona RN license, 5+ years RN experience, 2+ years hospital RN experience, and #J-18808-Ljbffr ISHE
- UnitedHealthcare seeks an experienced Senior Clinical Quality of Care RN in Arizona. The role involves reviewing and managing quality-of-care investigations for Medicaid/Medicare members, communicating findings, and preparing internal and external reports. Travel up to...QualitySeniorWork at office
$72.8k - $130k
About This Role The Senior Clinical Quality of Care RN will conduct quality of care investigations, manage... ...healthcare quality for Arizona Medicaid and Medicare members. Highlights Location:... ...care concerns. Conduct delegated oversight reviews of contractors performing...QualitySeniorFull timeFor contractorsWork at officeRemote workDay shift$72.8k - $130k
...Senior Clinical Quality of Care RN At UnitedHealthcare, we're simplifying the health care experience... ...are specific to Arizona Medicaid and Medicare members. This position is an Arizona... ...information Conduct delegated oversight reviews of contractors that perform...QualitySeniorMinimum wageFull timeFor contractorsWork experience placementWork at officeLocal areaRemote work- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct QOC investigations, review IAD portal cases, and prepare reports for internal and external customers. You will collaborate with Medical Directors to ensure QOC reviews comply with State, Federal...QualitySeniorRemote jobWork at office
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN in Arizona to conduct quality of care investigations and manage regulatory IAD processes. The role collaborates with Medical Directors to ensure compliance with state, federal and professional standards....QualitySeniorRemote jobWork at office
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN based in Arizona to conduct quality of care investigations for Medicaid/Medicare members. This hybrid role requires 5+ years of RN experience, unrestricted AZ license, and ability to travel up to 25% within...QualitySeniorRemote jobWork at office
- UnitedHealth Group seeks a Sr. Clinical Quality Consultant RN to drive STARS and quality improvement across the Inner West Valley Phoenix region. This hybrid role combines remote work with in-person meetings and trainings, supporting providers to achieve higher quality...QualitySeniorRemote work
$72.8k - $130k
...start Caring. Connecting. Growing together. The Sr. Clinical Quality Consultant RN will drive consistency, efficient processes and share... ...review experience ~ Billing and CPT coding experience ~ Medicare and/or managed care experience Pay is based on...QualitySeniorMinimum wageFull timeWork experience placementWork at officeLocal area- Katalyst CRO in Phoenix, AZ is seeking a senior Clinical Data Management (CDM) leader to guide data collection systems and vendor oversight across multiple studies. You will design... ...validation specs, ensuring high data quality and regulatory compliance. Lead CDM activities...QualitySenior
- UnitedHealthcare is seeking a Senior Clinical Quality of Care RN to conduct quality of care investigations, review regulatory IAD portals, and prepare reports for internal and external customers. This role collaborates with Medical Directors to ensure compliance with state...QualitySeniorRemote job
$78k - $156k
...StatesEmployment type: full timeCategory: Medical and Clinical AffairsIndustry: HealthcarePosted: 2026... .... The Opportunity The Senior Clinical Monitoring Lead (CML) serves... ...matter expert for clinical monitoring quality, oversight, and execution. This role partners with...QualitySeniorWork experience placementLocal areaRemote work- BD is seeking a Manager of Clinical Operations (Specimen Management) to lead a team of Clinical... ...will guide protocol development, TMF oversight, and cross-functional collaboration with... ...teams and CROs to ensure timely, quality execution. The role requires a strong background...QualitySenior
- **Position is Hybrid serving the Inner West Valley region of the Phoenix metro area, with proximity to Central Phoenix (S. Glendale, Avondale, Tolleson, Litchfield Park)*** (Time spent in the field, working from home and occasionally in the office for meetings or training...QualitySeniorWork at officeLocal area
$60.2k - $107.4k
...healthier communities and removing barriers to quality care. The work you do here impacts the... ...this program is to provide a front line clinical resource to provide education and support... ...: ~ Current and unrestricted RN compact license ~4+ years of acute nursing...QualitySeniorRemote jobMinimum wageFull timeWork experience placementLocal areaMonday to Friday$60.2k - $107.4k
...Family Advocate Support CARE - Senior Clinical Admin Nurse - Remote (2384907... ...and removing barriers to quality care. The work you do here impacts... ...: Current and unrestricted RN compact license Ability to... ...nursing experience 2+ years of Medicaid waiver experience Med-surg,...QualitySeniorRemote jobMinimum wageFull timeWork experience placementLocal areaMonday to Friday- UnitedHealth Group in Phoenix, AZ is seeking a Senior Clinical Quality of Care RN to conduct investigations, review medical records, and ensure... ...with state and federal regulations for Arizona Medicaid and Medicare members. This full-time daytime role offers a hybrid...QualitySeniorRemote jobFull timeWork at office
- ...level design, alignment, and oversight of professional practice standards... ...ensures consistent, high‑quality clinical outcomes and exceptional... ...advisor to the organization’s senior management on matters related... ...including but not limited to: RN; MD or DO; Driver’s License;...QualitySeniorFull timeShift work
- MMS, a data-focused clinical research organization, is seeking a senior data management professional to lead data management studies and collaborate with clients and suppliers. The role emphasizes quality, regulatory adherence, and cross-functional leadership. You will...QualitySenior
- ICON Strategic Solutions is seeking a Senior Clinical Research Associate in Arizona to oversee monitoring of clinical trial sites, ensuring... ...will lead monitoring tasks with technical depth and focus on quality and continuous improvement. You will monitor sites, conduct...QualitySenior
- ...is seeking a Family Advocate Support CARE - Senior Clinical Admin Nurse to provide individualized navigation... ...planning. The position requires an active RN license, 2+ years in acute and behavioral health nursing, and Medicaid waiver experience, with flexibility for remote...SeniorRemote job
- UnitedHealthcare is hiring a Family Advocate Support CARE - Senior Clinical Admin Nurse to provide individualized navigation... ..., outreach, and discharge planning. Required: RN license, 2+ years of relevant nursing experience, Medicaid waiver familiarity; preferred: Bachelor's in...SeniorRemote job
- ...Senior Medical Director, Clinical Development (Medical Monitoring) About the Company Rapidly growing... ...scientific discussions, and ensuring high-quality study execution. Applicants must... ...monitoring and clinical trial oversight, is required. The ideal candidate will...QualitySenior
- ...leadership impact?Join our team as a **Senior Charge RN** and oversee the daily operations... ...role, you will support staffing, quality outcomes, patient experience, and... ...position provides managerial, clinical, and administrative oversight to patients and staff. Uses depth...QualitySeniorShift workNight shift
$60.2k - $107.4k
...healthier communities and removing barriers to quality care. The work you do here impacts the... .... Connecting. Growing together The Senior Clinical Admin Nurse will be responsible for... ...Qualifications: Current and unrestricted RN compact license 4+ years of acute nursing...QualitySeniorRemote jobMinimum wageFull timeWork experience placementLocal areaMonday to Friday- ...experienced Registered Nurses for the NAH Flex Pool to provide high-quality patient care across multiple units. You will mentor colleagues,... ...physicians, participate in shared governance, and maintain clinical expertise while enjoying broader autonomy within a...QualitySeniorFlexible hours
$98k - $104k
...status quo by making quality care more... ...At One Medical Seniors we are transforming... ...benefits adults on Medicare and those who might... ...key member of the clinical team in each Senior... ...triage for patients Oversight of anti-coagulation... ...have: ~ Active RN license in Colorado...QualitySeniorFull timeTemporary workWork at office- ...seeking an experienced Registered Nurse (RN) to join our team and provide daily direct patient care in a senior-focused primary care setting. Reporting to... ...Friday schedule, with opportunities to improve clinical performance, quality, and patient experience across our clinics...QualitySeniorMonday to FridayDay shift
- Humana Inc. through CenterWell Senior Primary Care seeks a Clinical Care Nurse (RN) to support transitions of care, reduce avoidable readmissions, and drive Medicare Advantage Stars while improving patient outcomes. This clinic-based role requires collaboration with providers...QualityWeekday work
- ...direction and implementation of clinical systems for data collection... ...budgeting, resource planning, vendor oversight, EDC build and study timelines... ...to meet all applicable quality requirements and regulations,... ...Degree in scientific discipline (RN or advanced degree preferred)...QualitySenior
- ...improvement initiatives. You will lead a team focused on advancing documentation quality, engaging providers, and coordinating with HIM Coding and Care Coordination to promote accurate clinical documentation in a Phoenix, AZ setting. #J-18808-Ljbffr Texas Health...QualitySenior
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