Clinical Quality Review Lead for Regulatory Audits
$78.7k - $134.9kMedica
A nonprofit health plan is looking for a Supervisor of Quality Reviewers to oversee clinical reviews and regulatory audit operations. The ideal candidate will have a Bachelor's degree, significant clinical healthcare experience, and leadership skills. This role includes direct supervision of the quality review team and requires expertise in regulatory compliance. The position offers a full salary range of $78,700 – $134,900, subject to experience and qualifications, and includes a comprehensive benefits package. #J-18808-Ljbffr Medica
$78.7k - $134.9k
...connected care, where coordinated, quality service is the norm and every... .... The Supervisor, Quality Reviewers is responsible for leading day-to-day clinical review and medical record operations... ...complex, time-sensitive regulatory audits and quality initiatives. This role...QualityRegulatoryWork experience placementRemote work$45.9k - $78.6k
...where coordinated, quality service is the... ...valued. The Intake Lead provides advanced... ...grievances, appeals, and regulatory inquiries. This... ...ensure cases are audit-ready from intake... ...(e.g., Pharmacy, Clinical, Operations, Vendors... ...issuesimpactingquality or timelines. Reviews work for...QualityRegulatoryWork experience placementWork at office3 days per week- ...-to-day operations of the Utilization Management team, driving clinical excellence and ensuring regulatory compliance. You will supervise clinical staff, coordinate with vendor partners, and oversee quality improvement initiatives while maintaining strong customer service...QualityRegulatoryWork at office
$27.5 - $36.68 per hour
...ensuring adherence to all regulatory requirements and... ...and operational concerns.Reviews, researches, and resolves... ...payroll processes and quality standards.Coordinates daily... ...payroll execution.Audit, Controls & ComplianceOwns... ...employee experience.Leads and supports payroll projects...QualityRegulatoryFull timeWork experience placementWork at officeLocal areaRemote work3 days per week- Vivie in Minnesota seeks a Regional Clinical Support Nurse to lead clinical operations across multiple communities, overseeing resident assessments and care plans to ensure high-quality care and regulatory compliance. You will guide clinical teams to deliver person-centered...QualityRegulatory
- ...Independent Risk Review And Assessment Lead Analyst The Independent Risk Review... ...that enhance review quality, efficiency, and consistency... ...risk management, compliance, audit, or related disciplines.... ...risk management, including regulatory compliance requirements, operational...QualityRegulatoryTemporary workWork experience placementWork at office3 days per week
$93k - $189k
...Credit Review Team Leader The Credit Review Team Leader will report directly to the... ...procedures and compliance with legal and regulatory requirements, and evaluate results to determine... ...skills, ability to deliver high quality results while meet deadlines, department...QualityRegulatory$99.3k - $198.7k
...Manager, Clinical Data Review Abbott is a global healthcare leader that... ...spectrum of healthcare, with leading businesses and products in... ...management as well as assures that quality of services meets internal... ...in field(s) of expertise, regulatory requirements, and industry...QualityRegulatoryFor contractorsFor subcontractorWork at office$248.5k - $373k
...Connecting. Growing together. Clinical Advocacy & Support has an... ...coverage and medical claims reviews. Our role is to empower providers... ...coverage determinations, quality improvement and cost effectiveness... ...with policies, and regulatory and accreditation requirements...QualityRegulatoryRemote jobMinimum wageWork experience placementLocal area$35 - $63 per hour
...Itemized Bill Review (IBR) Clinical Appeals Reviewer Optum Insight is improving... ...improving risk management, quality and revenue growth. Ready... ...Must utilize expertise in auditing to review and provide... ...industry terminology, and regulatory guidelines Pay is based...QualityRegulatoryRemote jobHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to Friday$91.7k - $163.7k
...Accreditation And Regulatory Related Clinical Quality Improvement At UnitedHealthcare, we're simplifying the... ...improvement functions. These roles lead the reporting and analysis of member... ...assessments; serve as a technical advisor; review state or regional teamwork; and...QualityRegulatoryRemote jobMinimum wageFull timeWork experience placementWork at officeLocal area$78k - $156k
...spectrum of healthcare, with leading businesses and... ...Plymouth has an opening for Clinical Group Lead. This role... ...team regarding global regulatory reporting decisions.... ...a program that reviews the complaint process... ...process of continuous quality improvement and risk managementIdentify...QualityRegulatoryLocal areaWorldwideShift work$150k - $175k
...give them better quality of life. We develop... ...is responsible for leading a growing team to... ...and execution of clinical trials in collaboration... ...with legal and regulatory standards and... ...of Institutional Review Board (IRB) approvals... ...procedures.Support audit readiness and provide...QualityRegulatoryMinimum wageOngoing contractFull timeContract workTemporary workWork at officeLocal areaRemote workWorldwideNight shift3 days per week$88.8k - $152.3k
...care, where coordinated, quality service is the norm and... ...valued. The Category Lead is accountable for category... ...Quarterly Business Reviews (QBRs) and ongoing strategic... ...obligations, regulatory requirements, and risk... ...pre and post contracting audit Monitor compliance, manage...QualityRegulatoryContract workWork experience placementWork at office3 days per week$87k - $136k
Quality Analyst Lead | Salesforce job at Dahl Consulting. Minnetonka, MN. Contract Duration: 6 months... ...Ensure compliance with standards and regulatory requirements while tracking progress... ...family’s needs. For details, please review the DAHL Benefits Summary. #J-18808-Ljbffr...QualityRegulatoryContract work$78.7k - $134.9k
...connected care, where coordinated, quality service is the norm and every... ...This role supports Medica’s Clinical Optimization team by... ...operationalizing business and regulatory requirements across clinical... ...further information, please review the Know Your Rights notice from...QualityRegulatoryWork experience placementWork at office3 days per week$171k - $273k
...Job Title Director of Clinical Operations Job Description... ...against goals while leading complex negotiations with regulatory bodies, sites, and vendors... ...Medical, Regulatory, Legal, Quality, Procurement, and Finance... ...meetings, enrollment reviews, budget reviews, milestone...QualityRegulatoryFull timeContract workWork at officeLocal areaImmediate startWork visaRelocation package3 days per week- ...Clinical Project Manager We believe that great healthcare... ...by meeting company and regulatory requirements according to time, quality/scope, and budget... ...and risk mitigation. Lead sponsor study startup process... ...across the clinical team. Review and approve vendor...QualityRegulatoryWork at officeFlexible hours
- ...Renewable Energy Permitting Lead Serve as a Senior Permitting... ...a primary focus on Midwest regulatory processes including PSC, MPUC... ...developments. Direct environmental reviews under NEPA and equivalent... ...team members and ensuring quality, schedule, and budget...QualityRegulatoryLocal area
$134.6k - $230.8k
...yearJob Area: Medical & Clinical OperationsCompany:... ...removing barriers to quality care. The work you do... ...Healthcare. The Director leads the United Healthcare... ...orchestrates cross functional reviews and recommendations... ...with Regulatory and Compliance Teams to...QualityRegulatoryMinimum wageFull timeWork experience placementLocal areaRemote workFlexible hours- Fresenius Medical Care in Minnesota seeks a Clinical Manager to lead clinic operations, ensure quality patient care, and manage staff for dialysis services. This role emphasizes leadership, regulatory compliance, and patient outcomes within a dynamic healthcare environment...QualityRegulatory
$90k - $110k
...day easier As a Regional Clinical Support Nurse, you will serve... ...to ensure high-quality resident care and regulatory compliance. This role requires... ...well-being of residents. Lead and Develop Teams Supervise... ...further information, please review the Know Your Rights notice...QualityRegulatoryFull timeInterim roleWork at officeMonday to Friday$88.8k - $152.3k
...care, where coordinated, quality service is the norm and every... ...works within Medica’s Clinical Optimization team, leading strategic initiatives focused... ...initiatives align with regulatory, compliance, and organizational... ...information, please review the Know Your Rights ( notice...QualityRegulatoryWork experience placementWork at office3 days per week$78k - $156k
...timeCategory: Medical and Clinical AffairsIndustry:... ...healthcare, with leading businesses and... ...hearts, improve quality of life for thousands... .... Study Support · Review study documents... ...work complies with regulatory and compliance standards... ...Internal/External Audits · Key player in...QualityRegulatoryWork experience placementLocal areaRemote workRelocation$113.4k - $194.4k
...Summary The Pharmacy Clinical Governance Manager... ...responsible for leading the development,... ...governance processes, high quality clinical policy... ...Therapeutic class reviews Comparative... ...outdated criteria, or regulatory risk Ensure... ...criteria are defensible, auditable, and aligned with...QualityRegulatoryWork experience placementWork at office3 days per week$88.8k - $152.3k
...where coordinated, quality service is the norm... ...The Finance Manager, Clinical is responsible for leading financial planning,... ...financial performance, regulatory compliance, cost... ...internal and external audits and provide required... ...information, please review the Know Your Rights...QualityRegulatoryWork experience placementWork at office3 days per week$78.7k - $134.9k
..., where coordinated, quality service is the norm and... ...is part of the HEDIS Audit and Submissions team... ...Medica members, meet regulatory and accreditation... ...and audit processes, leads and facilitates cross... ...Coordinate with the Clinical Quality Review team and external vendors...QualityRegulatoryWork experience placementWork at office3 days per week- ...Senior Clinical Scientist If you're the kind of Clinical... ...center of Clinical, R&D, Regulatory, Therapy Development, and Quality—where procedural insight,... ...cross-functional alignment, reviews, version control, and... ...Development, and Quality Lead structured SME review...QualityRegulatoryShift work
$80k - $100k
...innovative, high-quality healthcare solutions... ..., safety, and regulatory compliance, serving... ...across a variety of clinical settings. Why join... ...Opportunities to lead process improvement... ...processes. Prepare and review journal entries,... ...with external audits and preparation of...QualityRegulatoryLocal area$125k - $135k
...As a global leader in clinical diagnostics, Beckman Coulter... ...Practice (GCP), and regulatory requirements.... ...conduct.Conduct regular reviews of clinical study data... ...address any performance or quality issues.Act as a key... ...internal and external audits and regulatory inspections...QualityRegulatoryFull timeWork experience placement
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