Quality Analyst | Telecommute
Samprasoft
Quality Analyst
Contract
Senior Analyst(s) will be responsible for end-to-end business process activities - creating, controlling and improving the performance guarantee processes related to Prior Authorization and Appeals.
Will lead process design and project implementation teams to assure program compliance and quality control for adherence to audit requirements based on governing bodies for the 19 states serviced by Community and State.
Responsible for diagnosing process improvement opportunities and developing solutions using principles of process excellence and related tools.
This position is also responsible for quality reporting, analysis, audits and for developing plans and programs to support continuous quality improvement using applicable tools.
May assist in the creation, implementation, and evaluation of Total Quality Management (TQM) programs surrounding PA and Appeal related performance guarantees.
May direct design, facilitation, training and evaluation of TQM incentive programs and may oversee quality improvement projects and teams in functional area.
The Prior Authorization Governance and Auditing Group provides audit and regulatory support related to Prior Authorization and Appeals for all clients.
The analyst(s) will serve as the regulatory subject matter expert during oversight and delegation audits performed by various clients.
Analyst(s) will be responsible to analyze and report OOC data, perform clinical review on all DOI inquiries to ensure the PA and appeal process are aligned with regulatory guidance.
Analyst(s) will lead data validation efforts for PA and Appeals including quality control for adherence to accreditation, state and federal program requirements.
Clinical validation includes review of prior authorization cases for clinical decision-making based on individual plan formulary and requirement and patient demographics.
The analyst(s) will ensure compliance to various regulations based on lines of business and plan design.
In addition to audit support, the analyst(s) will be involved with trending to identify process improvements to ensure compliance with applicable state and federal laws, business contract requirements, prevent untimely cases and maintain client relations.
Analyzes and investigates root cause of non-compliant cases.
Required Skills: Quality
Additional Skills: Quality Engineer, Analyst
This is a high PRIORITY requisition.
Samprasoft$45 per hour
...experience is necessary. Benefits Very competitive pay rate Weekly pay Work around your own schedule Learn about an exciting industry Telecommute (you can work from home, work or school) Most of the time you can keep the product you tested #J-18808-LjbffrRemote workHourly payWeekly payExtra incomeTemporary workPart timeFor contractorsSeasonal workWork from homeFlexible hours- ...the prestigious National Committee for Quality Assurance designation for its patient‑centered... ...The Clinical Quality Informatics Analyst II is responsible for managing the collection... ...Statistical Work Schedule Eligible for Telecommute Equipment Operated Photocopier, Personal...Remote workWork experience placement
- ...have a high school diploma, professional certification, and experience in physician medical coding across various specialties. The position offers flexibility to telecommute from anywhere in the U.S. and comes with comprehensive benefits. #J-18808-Ljbffr Crains ClevelandRemote job
$23.89 - $42.69 per hour
The Texas Health Institute is seeking a full-time Coding Quality Analyst in Plymouth, Minnesota. This position requires conducting reviews... ...along with relevant certifications. Employees can telecommute from anywhere in the U.S. The compensation ranges from $23.8...Remote workHourly payFull time$23.89 - $42.69 per hour
...Coding Quality Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...with your schedule. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges...Remote workHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to FridayShift work$29 - $52 per hour
...position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges... ...follow-up audits for providers who do not meet established quality standards Perform ad hoc audits in response to client requests...Remote workHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to FridayFlexible hours$24 - $43 per hour
...Coding Quality Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...occasional overtime. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges...Remote workHourly payMinimum wageFull timeTemporary workWork experience placementLive inWork at officeLocal areaMonday to FridayShift work- Job Summary The Clinical Quality Informatics Analyst II is responsible for managing the collection, organization, and input of complex data and... ...Medical Terms, Statistical. Work Schedule: Eligible for Telecommute. Equipment Operated: Photocopier, Personal Computer, 10-...Remote workWork experience placement
$23.89 - $42.69 per hour
...global scale. Caring. Connecting. Growing together. Coding Quality Analyst position is full time 40 hours/week Monday - Friday.... ...aligned with your schedule. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges...Remote workHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to FridayShift work$23.89 - $42.69 per hour
Position Overview The Coding Quality Analyst position is full time, 40 hours per week, Monday through Friday. Employees must be flexible... ...Overtime may be required on occasion. Eligible employees may telecommute from anywhere within the U.S. Four weeks of on‑the‑job...Remote workHourly payMinimum wageFull timeWork experience placementLive inLocal areaMonday to FridayFlexible hoursShift work$23.89 - $42.69 per hour
...Coding Quality Analyst Optum is a global organization that delivers care, aided by technology to help millions of people live healthier... ...high quality reviews. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough...Remote jobHourly payMinimum wageFull timeWork experience placementLocal area$70.1k - $126.2k
...including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: The Senior HEDIS Quality & Audit Analyst serves as an enterprise subject matter expert responsible for advanced HEDIS quality oversight, audit readiness, and...Remote workFull timePart timeH1bWork at officeWork from homeFlexible hours- ...AI Quality Analyst This is a remote position. AI Quality Analyst Reporting to Manager, Quality Engineering & AI Validation, focuses on validating the quality of AI-generated outputs, agent behaviors, and AI-assisted workflows. Builds benchmark scenarios, defines scoring...Remote work
- ...Partnering with clients during implementation, the full-time AI Quality Analyst will assess the quality and safety of AI-generated responses, translating client requirements into evaluation frameworks while working remotely. Key responsibilities Review and score AI responses...Remote workFull time
- ...To ensure high-quality deliverables within the Print Migration Program, the remote contract Quality Analyst will validate print trails, e-delivery configurations, and document outputs while collaborating with cross-functional teams to identify defects and maintain quality...Remote workContract work
- ...To support quality assurance initiatives, the full-time Quality Analyst II will participate in requirements gathering, create and execute test cases, and provide feedback on product quality while working remotely. Key responsibilities Participate in requirements gathering...Remote workFull time
$72.8k - $130k
Join UnitedHealthcare as a key member of the Quality Reporting Operations team, focusing on HEDIS® data reporting and compliance. This... ...in healthcare analysis. The position provides flexibility to telecommute within the U.S., while also requiring periodic office...Remote jobWork at office$72.8k - $130k
...experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of... ...better for everyone. You'll enjoy the flexibility to work telecommute from anywhere within the U.S. as you take on some tough challenges...Remote workMinimum wageFull timeWork experience placementWork at officeLocal area$23 - $27.02 per hour
...The Quality Analyst is responsible for quality assurance of new implementations, existing client benefit changes, and continuous process improvement. The Quality Analyst ensures every phase and feature of the client solution is audited and tested and that any potential...Remote workHourly payContract workTemporary workWork experience placementLocal area- ...Working remotely on a part-time basis, the Quality Control Analyst will perform quality control analysis of valuation reports, ensuring compliance with regulatory and client standards, while also managing communication with valuation providers and meeting production goals...Remote workPart time
- ...Quality Assurance Analyst - Consultant Columbia, SC 29201 Hybrid (4 days in office, 1 day remote) Candidate must be a South Carolina resident; relocation is not allowed. Responsibilities and qualifications are listed below: Required Skills Basic degree in a technical,...Remote workWork at officeRelocation
$55 - $62 per hour
Lehrer Family Chiropractic is seeking a Remote Clinical Quality Analyst in the United States. This part-time role involves reviewing clinical records, conducting quality assurance audits, and supporting compliance processes. The ideal candidate has a degree in healthcare...Remote workHourly payPart timeFlexible hours$21.64 per hour
...Maximus is currently hiring for Quality Control Analysts to join our Veterans Evaluation Services (VES) team. This is a remote opportunity. The Quality Control Analyst is responsible for reviewing Medical Disability Examination ("MDE") reports and Disability Benefits...Remote workContract workCurrently hiringWork at officeWork from homeHome officeMonday to Friday$40 per hour
A healthcare technology company is seeking medical experts for a remote position to assist in training AI models. Responsibilities include providing healthcare-related problems to AI chatbots and evaluating their output for accuracy. Candidates should have a medical degree...Remote workHourly payFor contractors- ...ensuring the accuracy of model performance. Candidates should be fluent in English and have a current or in-progress medical degree. This is a flexible, independent contractor position that pays hourly, starting at $40, with extra bonuses for high-quality work. #J-18808-LjbffrRemote workHourly payFor contractorsFlexible hours
$56.1k - $104.7k
...is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Senior Quality Assurance Analyst based in the United States. This role plays a key part in ensuring the quality, compliance, and continuous improvement...Remote jobFull timeWork at office- A healthcare technology company is seeking a HIM Analyst to help train AI models and evaluate the logic and accuracy of AI chatbots. This... ...made hourly, starting at $20, with bonuses available for high-quality work. Only applicants in the United States will be considered...Remote workHourly payFor contractorsFlexible hours
- ...public healthcare provider in Texas is seeking a Clinical Quality Informatics Analyst II to manage data for Quality Programs. This role... ...Informatics and certifications like CPHQ. The position supports telecommuting and involves working with reporting tools to provide insights...Remote work
$91k
...Job Title: QA Analyst – Call Center (Long-Term Temporary) Location: Cumberland, RI (Hybrid – Remote on Mondays and Fridays)... ...| Paid Time Off Job Description: Our client is seeking a Quality Assurance Analyst with a strong background in call center operations...Remote workTemporary workWork at officeMonday to Friday- ...Quality Assurance Analyst Sunshine Enterprise USA is retained by our valued client to search and recruit for the following executive opening: Job Title: Quality Assurance Analyst Location: Columbia, SC Hybrid (4 days in office, 1 days remote). Position Type: C...Remote workContract workWork at officeRelocation
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Quality Analyst | Telecommute. Be the first to apply!
- quality analyst Minneapolis, MN
- quality equipment Minneapolis, MN
- quality assurance quality control engineer Minneapolis, MN
- quality manufacturing Minneapolis, MN
- aerospace quality Minneapolis, MN
- water quality scientist Minneapolis, MN
- quality distribution Minneapolis, MN
- quality lead Minneapolis, MN
- quality improvement rn Minneapolis, MN
- water quality Minneapolis, MN


