Quality Assurance Coordinator jobs at MCMC - 517 jobs
Quality Analyst III (Hedis Analytics)
Caresource 4.9
Dayton, OH jobs
The Quality Analyst III is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance
Essential Functions:
Generate comprehensive reports, graphics and dashboards that effectively summarize and display data for key stakeholders
Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques and provide management level summaries that explain key findings
Provide technical expertise and guidance to team members on SQL, SAS, and DAX coding best practices, visualizations, and table locations
Interpret and maintain understanding of technical specification and other quality reporting requirements and ensure any changes are implemented and communicated with key stakeholders timely
Interact and work collaboratively with business partners on analysis, reports and data patterns to identify trends
Gather, understand and refine requirements for analytics requests including but not limited to HEDIS, Population Health, Pharmacy Quality, Accreditation, Health Equity, business development and RFP requests
Collaborate with IT teams to enhance data collection and reporting systems
Perform any other job duties as assigned
Education and Experience:
Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required
Master of public health (MPH), Business Administration (MBA), mathematics, statistics, or related field is preferred
Minimum of three (3) years of experience in data analysis and/or analytic programming is required
Minimum of three (3) years of HEDIS or similar healthcare quality performance metrics experience is required
3-5 years Programming experience (i.e., SQL, SAS) is required
Programming in DAX/Power BI is preferred
Health care delivery, clinical experience and/or payer experience is preferred.
Competencies, Knowledge, and Skills:
Intermediate proficiency level with Microsoft Office Suite
Complex problem-solving skills for solving multi-dimensional business questions Proficient in Programming language (i.e., two of SQL, SAS and/or DAX) is required
Managed Care Organization knowledge and familiarity
Graphic development & presentation skills
Exposure to statistical concepts strongly preferred
Critical thinking and active listening skills
Effective verbal and written communication skills
Ability to lead analytic efforts
Ability to serve as liaison with business partners
Knowledge of managed care and health care data coding
Ability to interface with IT teams, familiarity with MDS and advanced data architecture
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
#LI-GB1
$72.2k-115.5k yearly 1d ago
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Quality Analyst II - Hedis Analytics
Caresource 4.9
Dayton, OH jobs
The Quality Analyst II is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance.
Essential Functions:
Generate graphics that effectively describe, explore and summarize analyses for communication to appropriate parties
Responsible for completing the analysis process to determine best course of action for each inquiry/problem
Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques and provide management level summaries that explain key findings
Collaborate with team members on technical specifications and coding tactics
Assist in quality dashboard development and reporting using Power BI and other visual data tools
Gathers and understands requirements for analytic requests
Perform any other job duties as assigned
Education and Experience:
Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required
Minimum of two (2) year experience of HEDIS or similar quality healthcare performance metrics experience is required.
2 years Prior programming experience (i.e. SQL, SAS, Python or DAX) is required
Health care delivery and/or payer experience is preferred
Clinical experience is preferred
Competencies, Knowledge and Skills:
Proficient with Microsoft Office Suite
Proficient in minimum one of the programming skills (i.e., SAS, SQL, or DAX) required
Analytic skills for solving multi-dimensional business questions
Graphic development & presentation skills
Exposure to statistical concepts preferred
Critical listening & thinking skills
Effective verbal and written communication skills
Problem Solving skills
Knowledge of managed care and health care data coding
Ability to work with IT teams, familiarity with MDS and data architecture
Licensure and Certification:
None
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business
This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
#LI-GB1
$62.7k-100.4k yearly 3d ago
CX QA Specialist (Remote)
Primary.Health 4.1
San Francisco, CA jobs
Primary.Health is the engine behind your COVID-19 testing and vaccination programs. Our web-based platform provides government agencies, schools, healthcare facilities, and community based organizations the ability to quickly register participants, schedule appointments, arrange for easy onsite check-in and check-out, and exchange data between labs and state databases, easing the reporting process.
JOB TITLE: CX QA Specialist
REPORTING TO: Technical Program Manager
JOB TYPE: Full-time
LOCATION: Remote
JOB SCOPE: At Primary, we believe in tackling hard problems together as a team, with strong values around collaboration, accountability, and transparency while assisting participants in getting tested and vaccinated.
CX QA Specialist is responsible for assessing the performance quality of CX Support Specialists and ensuring a full understanding and implementation of company processes. The QA Specialist reports to the CX Lead, Quality Assurance. They'll monitor everything pertaining to quality with CX calls and emails in the Support Specialists files and provide their feedback which will roll up to the Team Leads and CX Management. They'll monitor inbound and outbound calls and emails to ensure accuracy and compliance guidelines are followed. They'll work closely with the CX Lead, Quality Assurance, Team Leads and management to ensure professionalism, competence, and capability. The ideal candidate pays close attention to detail, is organized and has strong written and verbal communication skills.
A proficiency with using Google Workspace apps (G Suite) and Chrome browser is ideal. The ideal candidate is detailed-oriented and organized. Is able to openly communicate with the CX team and Management.
MAJOR JOB DUTIES:
Monitor inbound and outbound inquiries (phone and email) to ensure accuracy and quality and is in accordance with company policies and procedures.
Ensure full participation and engagement in all company-related events and commitments.
Provide constructive feedback via QA form to CX leads so they can relay to CX Customer Support Specialists to further improve their skills, understanding, and knowledge.
Stays up to date with changes and new client processes and guidelines.
Act as a liaison between Team Leads and CX Support Team.
Contribute to team culture in a positive manner and foster a healthy and comfortable work environment.
Informs CX Lead, Quality Assurance and Management when an agent is on their final warning and assists with next steps such which can lead up to termination.
QUALIFICATIONS:
Pays attention to detail and is able to assist with processes, and documentation.
Sets a good example to CX agents and Team Leads.
Able to monitor according to QA guidelines and provide detailed notes and feedback on all CX Support Specialists.
Excellent written and typing skills. Proficient with Google suite.
Tech savvy with knowledge of telephone equipment and relevant computer programs such as Zendesk, Kustomer, Ujet and/ or other call center and ticketing software.
Primary embraces diversity. We are proud to be an equal opportunity workplace and do not discriminate on the basis of sex, race, color, age, sexual orientation, gender identity, religion, national origin, citizenship, marital status, veteran status, or disability status. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
$70k-97k yearly est. 60d+ ago
Patient Access Quality Assurance Coordinator
Ensemble Health Partners 4.0
Tyler, TX jobs
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
***This position is an onsite role, and candidates must be able to work on-site at the hospital.****
The Opportunity:
With little supervision, the Patient Access Quality Assurance Specialist will work directly with all levels of Patient Access leadership and the individual Patient Access Specialists and Sr. Patient Access Specialists. They will be responsible for auditing Patient Access calls, accounts, and work queues to ensure compliance and consistency to policy and procedure. They will be responsible for identifying trends and provide reporting for training/coaching purposes to both leadership and associates. In addition to auditing accounts, the auditor will ensure monthly quality scorecards are completed accurately and adhere to department standards and established metrics for quality.
This position pays between $17.00 - $18.15/hr based on experience
Job Responsibilities:
The QA specialist will be responsible for auditing Patient Access calls, accounts, and work queues to ensure compliance and consistency to policy and procedure.
They will monitor the quality audit tool and process and ensures accurate record keeping and audit scoring and system documentation.
They will be responsible for identifying trends and recommend quality and training needs of the department.
The auditor will partner with the leadership team to monitor, record and provide individual performance reporting for training/coaching purposes.
They will ensure monthly quality scorecards are completed accurately and adhere to department standards and established metrics for quality.
They will be responsible to collaborate with Patient Access leadership to remain updated on any new policy and procedure changes to make necessary changes on all associate scorecards.
Continuous research, development and implementation of new quality procedures and programs to ensure cutting edge ideas and efficiencies.
They will be expected to provide routine calibrations with the associates to further explain the score.
They will be expected to provide ad hoc audits requested by Patient Access leadership, in addition to normal account edits.
Experience We Love:
• 1 - 3 years of customer service experience
Required Qualifications:
• High School Diploma/GED Required
• CRCR Required within 9 months of hire
Other Preferred Knowledge, Skills and Abilities
Other 4 year/ Bachelors Degree
Minimum Years and Type of Experience: 2 years of Patient Access operations experience
Other Knowledge, Skills and Abilities Required:
Knowledgeable in Patient Access Services and Patient Access technology, applications, systems, processes.
Knowledgeable in all Microsoft Office products, with an emphasis in Excel.
Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
Energage Top Workplaces USA 2022-2024
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified 2023-2024
Innovation
Work-Life Flexibility
Leadership
Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
Associate Benefits - We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
Our Culture - Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
Growth - We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
Recognition - We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact *****************.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.
EEOC - Know Your Rights
FMLA Rights - English
La FMLA Español
E-Verify Participating Employer (English and Spanish)
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$17-18.2 hourly Auto-Apply 14d ago
Quality Assurance Coordinator, Registered Nurse
Sentara Healthcare 4.9
Suffolk, VA jobs
City/State Suffolk, VA Work Shift First (Days) Sentara Homecare and Hospice Services Newport News is seeking to hire a qualified individual to join our team as a Quality AssuranceCoordinator Registered Nurse. Full Time, Day Shift
Position Location:
Remote
Hourly Range: $33.53 - $55
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits.
Overview
Registered Nurse who establishes and maintains quality control systems and procedures that comply with Home Care standards. Performs regular audits and inspections to assess quality, compliance and adherence to internal and external standards. Analyzes data and feedback to identify areas for process improvement and quality enhancement. Identifies and addresses non-conformance issues, coordinates the resolution process and works with teams to prevent recurrence.
Education
* Associate's degree (Required)
Certification/Licensure
* RN (Required) - Active in Virginia
* BLS (Required within 90 days)
Experience
* 1 year experience required in Healthcare Quality Improvement or Data Analysis
* One year experience requires with the frail and elderly population for PACE
keywords: rn, registered nurse, home care, newport news, hampton roads, fulltime, talroo-nursing, indeed, home health, hospice, quality assurance, quality improvement, data analysis
Benefits: Caring For Your Family and Your Career
* Medical, Dental, Vision plans
* Adoption, Fertility and Surrogacy Reimbursement up to $10,000
* Paid Time Off and Sick Leave
* Paid Parental & Family Caregiver Leave
* Emergency Backup Care
* Long-Term, Short-Term Disability, and Critical Illness plans
* Life Insurance
* 401k/403B with Employer Match
* Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
* Student Debt Pay Down - $10,000
* Reimbursement for certifications and free access to complete CEUs and professional development
* Pet Insurance
* Legal Resources Plan
* Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission "to improve health every day," this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
$33.5-55 hourly Auto-Apply 8d ago
Quality Assurance Coordinator, Registered Nurse
Sentara Hospitals 4.9
Suffolk, VA jobs
City/State
Suffolk, VA
Work Shift
First (Days) Sentara Homecare and Hospice Services Newport News is seeking to hire a qualified individual to join our team as a Quality AssuranceCoordinator Registered Nurse.
Full Time, Day Shift
Position Location:
Remote
Hourly Range: $33.53 - $55
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits.
Overview
Registered Nurse who establishes and maintains quality control systems and procedures that comply with Home Care standards. Performs regular audits and inspections to assess quality, compliance and adherence to internal and external standards. Analyzes data and feedback to identify areas for process improvement and quality enhancement. Identifies and addresses non-conformance issues, coordinates the resolution process and works with teams to prevent recurrence.
Education
Associate's degree (Required)
Certification/Licensure
RN (Required) - Active in Virginia
BLS (Required within 90 days)
Experience
1 year experience required in Healthcare Quality Improvement or Data Analysis
One year experience requires with the frail and elderly population for PACE
keywords: rn, registered nurse, home care, newport news, hampton roads, fulltime, talroo-nursing, indeed, home health, hospice, quality assurance, quality improvement, data analysis
Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave • Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down - $10,000• Reimbursement for certifications and free access to complete CEUs and professional development•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
$33.5-55 hourly Auto-Apply 2d ago
QA Financial Auditor II
Healthfirst 4.7
Remote
The Quality Assurance Financial Auditor II is responsible for performing Quality Assurance Audits of financial processes completed by internal employees and outsources vendors to ensure compliance with policies, procedures, and quality standards to mitigate financial risk. You will investigate, audit, conduct root cause analysis, handle processing of determinations, and track/trend findings under minimal supervision.
This position is 100% Remote.
Scope of Responsibilities:
Conduct moderately complex to complex quality audits of provider claims, pre-payments and post-payments including high-dollar and specialized claims across multiple lines of business, claim types and products.
Audit the work of more junior auditors and identify opportunities for coaching and/or training.
Identify and communicate issues identified through audits and recommended solutions relevant to business operations.
Assist management in preparing departmental reports policies and procedures.
Mentor and coach Financial and/or Operations QA auditors.
Participate as a Subject Matter Expert on various process improvement projects designed to meet departmental and operational needs.
Assist with performing User Acceptance Testing (UAT) on system enhancements or corporate projects in partnership with Business Operations
Analyze errors and determine root causes for appropriate classification.
Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance to ensure the quality of the network.
Review and investigate claims and encounters for medical, facility, pharmacy, dental and vision services including contractual provisions, authorizations and Healthfirst policy and procedure.
Prepare written reports concerning investigation activities and present results of investigations to senior staff.
Complete subsequent auditing and handling of specific claims and appeal requests including processing where applicable, tracking, documenting, reporting and dispersal of findings and recommendations.
Review the accuracy and efficiency of existing training materials.
Minimum Qualifications:
Audit experience with the investigation, determination and reporting of financial processes.
Work experience in Microsoft Office suite of applications including advanced Excel (formatting formulas, managing data, filtering results), Word (creating and editing documents), PowerPoint (creating and editing presentations)
Experience conducting root cause analysis in an auditing capacity.
Experience conducting analytical work and providing creative ideas for problem solving.
Work experience requires written and verbal communication that is clear, concise, grammatically correct, and professional.
Experience handling confidential information.
Associate degree from an accredited institution.
Preferred Qualifications:
Bachelor's degree from an accredited institution
Audit experience with the investigation, determination and reporting of financial processes
specifically around Healthcare Claims Adjudication and Claims Processing
Ability and willingness to handle increasing workload and responsibility
Willingness and ability to learn and evaluate new information, both technical and procedural
ICD10 certification
Basic foundation of SQL, Tableau, and SharePoint
Knowledge of at least two or more lines of business such as NY Medicare, Medicaid, Family Health Plus, Child Health Plus
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to *********************** or calling ************ . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC.
Know Your Rights
All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is ********************, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $68,900 - $99,620
All Other Locations (within approved locations): $61,300 - $89,440
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
$68.9k-99.6k yearly Auto-Apply 14d ago
QA Auditor, Quality Assurance - Remote
Healthfirst 4.7
Remote
**Scope of Responsibilities** **:** + Conduct quality audits of A&G items including grievances, pre-service appeals, and post service appeals utilizing appropriate sources of information; including eligibility, claims, authorizations, service forms, faxes, and any additional information required to complete the request. Analyze errors and determine root causes for appropriate classification, trending, and remediation.
+ Record/track quality assessment scores and provide feedback to reduce errors and improve processes and performance to ensure quality.
+ Review and investigate appeals and grievances requests to ensure all requests are identified, classified, and fully resolved in a compliant manner.
+ Present results of investigations to senior staff and prepare written reports concerning investigation activities.
+ Subsequent auditing and handling of specific appeal and grievance requests including processing where applicable, tracking, documenting, reporting and dispersal of findings and recommendations.
+ Identify defects and improve departmental performance by supporting quality, operational efficiency and production goals.
+ Assist in the development of departmental policies and procedures; reviews the efficiency of existing training.
+ Meet established time frames and rates of performance for the quality and quantity of work for the position.
+ Participate in regulatory and mock audit activities including universe review, universe scrubbing, risk analysis, timeliness assessment, and case walkthrough activities
+ Additional duties as assigned
**Minimum Qualifications** **:**
+ Experience with the investigation, resolution, and reporting of appeal and grievance processes.
+ Experience in Microsoft Office suite of applications including Excel (formatting formulas, managing data, and filtering results), Word (creating and editing documents), PowerPoint (creating and editing presentations).
+ High School Diploma or GED from an accredited institution.
**Preferred Qualifications** **:**
+ Associate degree from an accredited institution.
+ ICD10 certification.
+ Experience in an Auditing capacity conducting root cause analysis.
+ Knowledge of at least two or more lines of business such as Medicare NY/NJ, Medicaid, Family Health Plus, Child Health Plus, NH Family.
+ Experience handling confidential information.
+ Compliance & Regulatory Responsibilities: Knowledge of state and federal appeal and grievance regulatory requirements.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
$58k-90k yearly est. 5d ago
Provider Network Quality Coordinator
Brigham and Women's Hospital 4.6
Somerville, MA jobs
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
Responsible for supporting the provider data quality improvement and compliance initiatives by providing operational assistance. This role involves coordinating quality activities, maintaining accurate records, preparing reports, and facilitating communication across departments, ensuring the organization meets regulatory standards and continuously improves provider data quality.
Essential Functions
* Collects, organizes, and maintains data related to provider data measures, audits, and performance metrics. Assists in data analysis and interpretation, providing administrative support for quality improvement projects.
* Monitors compliance with regulatory standards and reports any discrepancies or areas of concern to the Provider Network Growth team.
* Contact healthcare providers and facilities listed in the provider directory via phone outreach.
* Validate key provider information, including: practice name and address, phone number, office hours, whether the provider is accepting new patients, languages spoken, and network participation
* Document and report findings using internal data collection tools or templates.
* Identify and flag discrepancies or potential directory errors.
* Follow standardized scripts and procedures to ensure consistency and regulatory compliance.
* Work with internal teams (e.g., provider relations, compliance) to report trends or escalate issues.
* Maintain a high level of professionalism and neutrality during all interactions.
* Meet established call quotas and documentation deadlines.
Qualifications
Education
* High School Diploma or Equivalent required
* Associate's Degree or Bachelor's Degree preferred
Experience
* At least 1-2 years of experience in an administrative or support role, preferably within a healthcare setting required
* At least 1-2 years of experience in quality control, assurance, accreditation or other related role preferred
Knowledge, Skills, and Abilities
* Familiarity with healthcare quality measures, regulatory requirements, and accreditation standards is a plus.
* Strong organizational, communication, and interpersonal skills.
* Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and data management software.
* Ability to handle multiple tasks simultaneously and work effectively in a fast-paced environment.
Additional Job Details (if applicable)
Working Conditions
* While a mostly remote role, you would attend team meetings every quarter at the office in Assembly Row, Somerville
Remote Type
Hybrid
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$21.78 - $31.08/Hourly
Grade
4
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$21.8-31.1 hourly Auto-Apply 12d ago
Compounding Quality Assurance Specialist
Johns Hopkins Medicine 4.5
Baltimore, MD jobs
The Compounding Quality Assurance Specialist reports to the Assistant Director Pharmacy Compounding Services and is responsible supporting the pharmacies in the Johns Hopkins Health System with compounding compliance. This individual will positively affect patient care by participating in quality assurance, regulatory compliance, facilities/equipment maintenance, staff education/training, and applicable documentation.
Shift:
Full Time (40 hours)- This position is approved for some remote work.
Day Shift 8:00am - 4:30pm
Weekends may be required
Education:
Requires a high school diploma or equivalent
College degree preferred
Licensure/Certification:
Current Maryland Board of Pharmacy Registration required.
PTCB pharmacy technician certification required.
Advanced certifications such as PTCB Compounded Sterile Preparation (CSPT ) and/or ASHP Compounded Sterile Preparations Certificate preferred.
JHH Intravenous (IV) Certification (includes aseptic technique and hazardous substance handling) within 90 days of hire.
Required Work Experience:
Minimum 2 years of experience in the preparation of nonsterile and sterile compounding
Hospital pharmacy, pharmacy infusion service, or 503B experience preferred.
Advance training in compounding, microbiology, or laboratory experience desired.
Knowledge, Skills and Abilities:
Comprehensive understanding of inpatient and ambulatory pharmacy operations, procedures, and equipment
Knowledge of pharmacy terminology, metric system weights/measures, and compounding practices
Thorough understanding of hazardous drug handling requirements
Strong attention to detail
Ability to independently complete and lead projects
Understanding and application of aseptic technique, and extensive knowledge in compounding standards USP , and preferred
Analytical ability to recognize and solve problems in assigned areas
Excellent prioritization, customer service skills and the ability to exercise initiative and judgment
Interpersonal skills necessary to obtain, verify and exchange information with third party vendors, supply chain, pharmacy, facilities, environmental care services, and hospital epidemiology and infection control
Proficient written and verbal communication with proven ability to work effectively with others
Aptitude to serve as a role model for compounding personnel
Methodical ability to maintain records
Proficiency to type a minimum of 40 words per minute
Proficient computer skills with demonstrated analytical experience and data retrieval is preferred
Ability to utilize presentation programs, word processing, spreadsheet software, and/or graphics applications is highly desired
The Compounding Quality Assurance Specialist will:
Conduct routine pharmacy audits and employee obeservations for JHH/JHHS to evaluate aseptic technique and compliance with procedures
Actively participate in the JHHS USP Committee, contributing to projects and supporting follow up
Develop and deliver JHH/JHHS training as needed to support regulatory and operational standards
Support sites with compounding or USP-related questions
Administer aseptic competencies/media fill test for select employees
Schedule and coordinate JHH equipment maintenance annually
Provide support to the cleanroom certifier as needed for JHH monthly sampling and certifications
Manage centralized coordination and purchasing of media fill supplies to support JHH employee aseptic competency assessments
Coordinate with vendors for JHH compounding needs, including scheduling of hazardous drug wipe sampling
Maintain and update JHH spreadsheet of microbiology results of monthy sampling in compounding areas
Salary Range: Minimum $23.00/hour - Maximum $37.97/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.
In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.
JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins!
Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.
Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Company info:
Graceworks Lutheran Services is a not for profit organization serving over 2000 older adults and adults with disabilities. We are a leader in offering services and settings that inspire and support a sense of home when people experience challenging and changing circumstance related to aging and living with disabilities.
Offering skilled nursing and therapy services, Bethany Village Home Health Care makes it easier for seniors to recover at home and live independently. Caregivers can feel peace of mind knowing their loved one is being carefully and faithfully served
This will be a Full-Time day shift position
Pay Range: $29.00 - 35.00 / hour based on experience
Position Qualifications:
Minimum Qualifications
: Registered Nurse or Licensed Physical Therapist. Valid driver's license with a safe driving record. Proof of auto insurance.
Minimum Experience
: Two years of Clinical experience with at least one year home health care experience, compliance or auditing. Familiarity with Joint Commission Home Care standards is recommended. Strong analytical and documentation review stills as well as the ability to work independently in a remote environment.
Position Summary:
The Quality Assurance/Quality Improvement Coordinator provides quality oversight and Joint Commission readiness through structured charge reviews, standards tracking, and trend analysis. This role ensures ongoing compliance with Joint Commission (TJC), Home Care standards and supports continuous quality improvement.
Position Accountabilities and Performance Criteria
:
Conduct routine chart audits using defined sampling methods, ensuring documentation is accurate, complete, timely and meets policy and regulatory standards.
Track, monitor and report on compliance with applicable Joint Commission Home Care (JCHC) standards to include, but not limited to patient rights, consents, advance directives, grievance documentation.
Track, monitor and report on compliance with applicable JCHC standards regarding assessment and care planning ensuring they are timely, accurate, aligned with Physician orders and have patient specific goals and interventions.
Track, monitor and report on compliance with applicable JCHC standards of timely completion of documentation, required forms are complete, documentation is consistent upon all disciplines and identify if late, incomplete, missing or trends are emerging.
Track, monitor and report on compliance with applicable JCHC standards of infection control to include documentation, compliance, and tracking.
Track, monitor and report on compliance with applicable JCHC standards of medication management to include documentation accuracy, medication reconciliation and education.
Tracks Performance improvement initiatives as identified or directed and helps identify trends or patterns.
Prepare quarterly reports summarizing audit findings, Joint Commission risks, trends and patters and communicates to the Director.
Uses knowledge, experience, and other resources as necessary to make logical decisions and solve problems
Uses position to set positive, attainable expectations, objectives, and goals for others within the organization.
Adheres to company infection control and safety policies, including reporting issues related to infection control and safety, and demonstrates use of infection control and safety policies in job positions.
Recognizes when others need information, assistance or direction and offers/provides help.
Assists in orientation and education of new and current staff.
Adhere to all policies and procedures of the organization as well as federal and state laws.
Perform all other duties as assigned.
PHYSICAL REQUIREMENTS:
Frequent bending is required, walking, sitting, and standing is involved 33% or more of the time. Heavy lifting is required up to 50 lbs. of force occasionally and/or 20 lbs. frequently, and/or up to 10 lbs. constantly to move objects. Potential for exposure to heavy weight bearing > 150 lbs. alone in sudden emergency situations.
Benefits:
As a team member at Graceworks Lutheran Services, you'll enjoy:
Competitive wages and paid training
Paid Holidays
Available medical and dental coverage, long-term disability and life insurance, 403(b) retirement account, and vision discount program for qualified full-time employees
Tuition Reimbursement and scholarship opportunities
Employee referral bonuses
We are an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
$29-35 hourly Auto-Apply 1d ago
Quality Assurance Review Specialist I
Verisma Systems Inc. 3.9
Remote
Quality AssuranceReview Specialist I The Quality Assurance (QA) Review Specialist - performs review functions to ensure that disclosures of PHI and PI are accurate and complete and comply with client protocols, state and federal privacy laws and regulations and/or with policies and procedures regarding HIPAA, PHI and PI. This position may be performed remotely.
Duties & Responsibilities:
* Reviews authorizations and requests for records to ensure that all pertinent information is contained on these forms and the dates are valid and relevant to the release process.
* Verifies that the attached medical records correlate to the authorization and request and documentation encompasses that patient only.
* Follows all Quality Assurance policies, procedures and job aids.
* Proactively communicates with Manager or Supervisor regarding further clarification and when additional work is needed.
* Actively participates with QA Team Meeting discussions.
* Sends notifications to requestor when applicable
* Communicates with company personnel in a professional and friendly manner
* Communicates with Release of Information Specialists and Client Site Managers on issues pertaining to quality review.
* Attends and completes on time, all required training sessions provided by Verisma
* Meets accuracy standards and performance indicators established by the Company
* Performs other appropriate duties as assigned to meet the needs of the department and the Company
* Consistently live by and promote Verisma Core Values
Minimum Qualifications:
* Must be detail oriented
* HS Diploma or equivalent, additional education in Health Information is preferred
* RHIT certification, CHDA certification or the ability to take and pass the course is preferred
* Knowledge and ability to use components of Microsoft Office Suite to complete tasks and possess the ability to learn new software applications
* 2 years' experience in a professional office environment or healthcare setting, preferred with medical terminology knowledge
* Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
* Must be able to communicate clearly and concisely to relay information to other departments
* Must be able to work independently
$59k-86k yearly est. 2d ago
Provider Network Quality Coordinator
Massachusetts Eye and Ear Infirmary 4.4
Somerville, MA jobs
Site: Mass General Brigham Health Plan Holding Company, Inc.
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.
Responsible for supporting the provider data quality improvement and compliance initiatives by providing operational assistance. This role involves coordinating quality activities, maintaining accurate records, preparing reports, and facilitating communication across departments, ensuring the organization meets regulatory standards and continuously improves provider data quality.
Essential Functions
-Collects, organizes, and maintains data related to provider data measures, audits, and performance metrics. Assists in data analysis and interpretation, providing administrative support for quality improvement projects.
-Monitors compliance with regulatory standards and reports any discrepancies or areas of concern to the Provider Network Growth team.
-Contact healthcare providers and facilities listed in the provider directory via phone outreach.
-Validate key provider information, including: practice name and address, phone number, office hours, whether the provider is accepting new patients, languages spoken, and network participation
-Document and report findings using internal data collection tools or templates.
-Identify and flag discrepancies or potential directory errors.
-Follow standardized scripts and procedures to ensure consistency and regulatory compliance.
-Work with internal teams (e.g., provider relations, compliance) to report trends or escalate issues.
-Maintain a high level of professionalism and neutrality during all interactions.
-Meet established call quotas and documentation deadlines.
Qualifications
Education
High School Diploma or Equivalent required
Associate's Degree or Bachelor's Degree preferred
Experience
At least 1-2 years of experience in an administrative or support role, preferably within a healthcare setting required
At least 1-2 years of experience in quality control, assurance, accreditation or other related role preferred
Knowledge, Skills, and Abilities
Familiarity with healthcare quality measures, regulatory requirements, and accreditation standards is a plus.
Strong organizational, communication, and interpersonal skills.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and data management software.
Ability to handle multiple tasks simultaneously and work effectively in a fast-paced environment.
Additional Job Details (if applicable)
Working Conditions
While a mostly remote role, you would attend team meetings every quarter at the office in Assembly Row, Somerville
Remote Type
Hybrid
Work Location
399 Revolution Drive
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
Pay Range
$21.78 - $31.08/Hourly
Grade
4
At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.
EEO Statement:
8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************.
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
$21.8-31.1 hourly Auto-Apply 13d ago
Quality Intern (Mentor, OH, US, 44060)
Steris Corporation 4.5
Mentor, OH jobs
At STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. The Quality Engineering Intern will support our quality team by performing preliminary research, data analysis, and testing intended to better define process improvement opportunities to meet corporate initiatives and to support compliance requirements.
This intern will have the opportunity to assist with maintaining and improving the quality system in accordance with the requirements of, as appropriate, the following standards: IS0 9001, ISO 13485, MDSAP, FDA 21 CFR Part 820/211, EU MDR and other applicable standards. This role also will help support complaint/CAPA investigations, supplier quality improvement, operations production and process controls, and product and service quality improvement with the use of statistical techniques and other accepted quality principles. This role executes activities concerned with the development, implementation, maintenance, and continuous improvement of STERIS quality systems.
Key Program Info:
* Dates: Summer 2026 (May-August)
* Location: Mentor, OH
* Work Environment: Onsite
* Hours: full-time for the duration of your internship
What You'll Do as a Quality Engineering Intern
* Collect and analyze data.
* Help implement processes and procedures to improve efficiency and quality.
* Organize and document testing and product development process.
* Work as a collaborative team member in engineering projects.
* Interface with cross-functional teams.
* Communicate and present testing results and milestones (Microsoft Office Tools/Excel/PowerPoint/etc.).
* Assist in efforts associated with Installation Qualifications, Operational Qualifications and Process Qualifications.
* Assist in getting cycle time data and analysis and articulate process improvement recommendations, both written and verbally.
* Assist in Lean tools and principles including set-up reduction, standard work, value stream mapping, A3 problem solving.
The Experience, Skills and Abilities Needed
Required:
* Currently pursuing a bachelor's degree in engineering - mechanical, industrial, or biomedical preferred.
* At minimum, sophomore year requirements must be completed by program start (May 2026)
* Ability to collect & analyze data
* Proficient in Microsoft Word, Excel, and PowerPoint
Preferred:
* Previous internship or co-op experience within a technical field
* Experience in SolidWorks
* Completed coursework in Statistics
* Involvement in engineering student organizations or competition teams
Other:
* Organizational, communication, problem solving, and troubleshooting skills.
Pay range for this opportunity is $20-25/hr.
Minimum pay rates offered will comply with county/city minimums, if higher than range listed. Pay rates are based on a number of factors, including but not limited to local labor market costs, years of relevant experience, education, professional certifications, foreign language fluency, etc.
STERIS offers a comprehensive and competitive benefits portfolio. Click here for a complete list of benefits: STERIS Benefits
Open until position is filled.
STERIS is an Equal Opportunity Employer. We are committed to equal employment opportunity to ensure that persons are recruited, hired, trained, transferred and promoted in all job groups regardless of race, color, religion, age, disability, national origin, citizenship status, military or veteran status, sex (including pregnancy, childbirth and related medical conditions), sexual orientation, gender identity, genetic information, and any other category protected by federal, state or local law. We are not only committed to this policy by our status as a federal government contractor, but also we are strongly bound by the principle of equal employment opportunity.
$20-25 hourly 1d ago
Quality Health Coordinator
Tampa Family Health Centers 4.1
Tampa, FL jobs
The Quality Coordinator at TFHC is responsible for overseeing and improving the quality of healthcare services provided across TFHC's clinics. This role ensures compliances with federal, state, and organizational standards, promotes patient safety, and drives continuous quality improvement initiatives to enhance patient-centered care in alignment with TFHC's mission to provide innovative, high-quality, integrated care.
Essential Duties & Functions
• In conjunction with the Director of Quality , assists with implementing the organization's quality improvement plan in accordance with the mission and strategic goals of the organization, federal, state laws, regulations, and accreditation standards.
• Collect, analyze, and report data on clinical performance, patient outcomes, and quality metrics using electronic health record (EHR) systems.
• Evaluate trends and communicate quality-related findings, presenting results of improvement initiatives and ongoing performance measures of clinical processes to TFHC senior leadership in a timely and accurate manner.
• Conduct regular audits of clinical process, prepare reports for leadership, and recommend corrective actions to address deficiencies.
• Responsible for timely completion of chart reviews and audits; has ownership for measurable results including HEDIS goal/ expectations, patient experience, employee engagement, and quality improvement.
• Develops, implement and monitor quality improvement programs to enhance health outcomes.
• Works collaboratively with other departments to carry out QI processes and projects using PDSA model.
• Serve as a quality champion to promote quality and improvement processes throughout the organization.
• Ensure adherence to regulatory standards (e.g., HRSA, Joint Commission and CMS) and TFHC policies and procedures.
• Monitor and address patient safety concerns, including reviewing abnormal test results and coordinating follow up care as needed.
• Collaborate with healthcare teams, including physicians, nurses, and medical support staff, to promote a culture of quality and safety.
• Support TFHC's mission by participating in patient education programs or community health initiatives as needed.
• Resources expert for departments in area of process improvement as it relates to quality improvement activities.
• Collaborate with senior leaders to process and monitor risk management review and investigation; responsible for investigation all issue, trends or risk factor that present potential risk to patient and staff.
• Adhere to all HIPAA, OSHA, and accreditation agency rules and requirements.
• Perform additional task as assigned to support TFHC's goals of accessible, high-quality care.
Required Education, Certifications, Licenses, & Training
• Bachelor's degree in healthcare administration, nursing, public health, or a related field, preferred.
• Proficiency in data analysis and reporting, including EHR navigation.
• Strong organizational and communication skills to coordinate across teams and sites.
• Knowledge of quality improvement methods (e.g., PDSA, Six Sigma)
• Certification in healthcare quality is a plus but is not always required
Required Years of Experience
• Minimum 1 year of experience in healthcare quality improvement, clinical operations, or a related field. Experience in community health or FQHC settings preferred.
Required Knowledge, Skills, and/or Abilities
• Excellent communication skills, both written and oral.
• Ability to work effectively with a diverse team of healthcare professionals.
• Demonstrated ability to ensure compliance with healthcare regulations and standards.
• Knowledge of computer systems and applications, including Microsoft Office software and EHR systems such as EPIC.
• Ability to analyze and interpret complex data and prepare comprehensive reports.
• Ability to collaborate with diverse healthcare professionals.
• Ability to travel between TFHC clinic sites and work in a fast-paced environment. With the ability to work remotely in hybrid models.
• Ability to effectively define problems, collect data, establish facts, and draw valid conclusions
• Demonstrated presentation skills.
• Knowledge of Stated and Federal regulations and requirements related to patient care
$63k-79k yearly est. Auto-Apply 60d+ ago
QA Engineer
Ihc Specialty Benefits 4.4
Alaska jobs
We are seeking a proactive QA Engineer who will work alongside business analysts, product managers, and developers to test daily development tickets, coordinate and execute User Acceptance Testing (UAT), and lead the development and maintenance of automated regression tests.
This role is critical in ensuring product quality across releases and features. You will work across manual and automated testing efforts, with a strong focus on Selenium-based test automation and supporting the team in delivering reliable, high-quality software.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Execute daily manual testing for development tickets returned for QA.
Collaborate with analysts, developers, and stakeholders to define and write test cases based on requirements.
Manage and coordinate UAT efforts, including obtaining stakeholder sign-off for new features and releases.
Identify, document, and track software defects using issue-tracking systems (e.g., Jira).
Lead the design, development, and maintenance of automated test scripts using Selenium or other automation frameworks.
Manage and maintain the regression test suite, ensuring automated tests are regularly executed and updated.
Work closely with development teams to understand new features and ensure test coverage.
Participate in Agile ceremonies such as sprint planning, daily stand-ups, and retrospectives.
Continuously improve QA processes and recommend automation and tooling enhancements.
Qualifications
REQUIREMENTS
3+ years of QA experience, with both manual and automation testing responsibilities.
Hands-on experience with Selenium WebDriver and automation frameworks (e.g., TestNG, JUnit, or Pytest).
Experience writing and maintaining automated regression suites.
Proficiency in writing test cases, test plans, and test scripts from requirements or user stories.
Experience with tools such as Postman for API testing is a plus.
Familiarity with bug tracking and test management tools (e.g., Jira, Zephyr, TestRail, Asana).
Excellent verbal and written communication skills.
Strong analytical and problem-solving skills.
Experience with Microsoft Office and Google Workspace tools.
Able to work independently, manage time effectively, and drive testing efforts to completion.
Knowledge of HIPAA Privacy Rules is a plus (if relevant to your product).
Preferred Skills (Nice to Have)
Experience with CI/CD tools (e.g., Jenkins, GitLab CI) for integrating test automation.
Knowledge of performance testing tools like JMeter or LoadRunner.
Experience testing in healthcare or other compliance-heavy industries.
Familiarity with version control systems like Git.
CERTIFICATES, LICENSES, REGISTRATION
IT, or equivalent, relevant work experience in Development QA
PAY TRANSPARENCY
The base pay for this role in the Akron Ohio office is: $70,000 - $90,000 per year. You are also eligible for employee benefits medical, dental, vision, life, and participation in the company 401(k) plan. Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience.
SUPERVISORY RESPONSIBILITIES
none
Why Join Us?
You'll help shape and scale our testing and automation processes from the ground up.
Work closely with a passionate, cross-functional product and engineering team.
Make a direct impact on the quality of our platform and user satisfaction.
Enjoy a collaborative work culture with room for growth..
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Small Motor Skills: Picking, pinching, typing or otherwise working primarily with fingers rather than with whole hand or arm, as in handling.
Speaking: Expressing or exchanging ideas by means of spoken word. Those activities in which require detailed or important spoken instructions must be conveyed to other workers accurately and quickly.
Hearing: Ability to receive detailed information through oral communication with or without correction.
Repetitive Motion: Substantial movement (motions) of the wrist, hands, and fingers.
WORK ENVIRONMENT
This Hybrid Remote / In-office role provides the opportunity to gain knowledge while collaborating with co-workers while also considering a life work balance.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Normal office environment with controlled temperature.
ADDITIONAL REQUIREMENTS
The company reserves the right to determine if this position will be assigned to work on-site, remotely, or a combination of both. Assigned work location may change. In the case of remote work, physical presence in the office/on-site may be required to engage in face-to-face interaction and coordination of work among co-workers.
COMPUTER PROGRAMS USED ON A DAILY BASIS
Google Apps
Microsoft Office Suite
Microsoft Azure Storage
Asana
RapidAPI
Adobe Acrobat
INSXCloud proprietary software application
$70k-90k yearly 10d ago
Specialist I, Quality Assurance - Quality Operations
Abeona Therapeutics Inc. 4.0
Cleveland, OH jobs
About Abeona Our Values: Patient First | Innovation | Integrity | Determination | Trust Join us in making cure the new standard of care. At Abeona Therapeutics, we exist for our patients and their caregivers; their needs guide our decision-making. We challenge ourselves to think differently, move quickly, and deliver solutions. We hold ourselves to the highest ethical and quality standards. We persevere with resilience and focus to achieve our mission. We build trust through humility, mutual appreciation, openness, and respect.
Company Description
Abeona Therapeutics Inc. is a commercial-stage biopharmaceutical company focused on developing cell and gene therapies for serious diseases. Notably, Abeona's ZEVASKYN (prademagene zamikeracel) is the first autologous cell-based gene therapy treating wounds in adults and pediatric patients with recessive dystrophic epidermolysis bullosa (RDEB). The company's cGMP manufacturing facility in Cleveland, Ohio, is dedicated to producing ZEVASKYN. Abeona's portfolio includes adeno-associated virus (AAV)-based gene therapies for ophthalmic diseases with unmet medical needs, and their novel AAV capsids aim to improve treatment outcomes for various debilitating conditions.
Position Overview
The Specialist I, Quality Assurance performs routine activities associated with manufacturing of cell and gene therapy products at the Abeona Therapeutics Inc. site in Cleveland, OH. This position supports the maintenance of the quality systems in support of a cGMP Operation for Manufacturing logistics processes relating to Abeona Manufactured Media batch record review and release from start to end of manufacturing activities, in-process sampling / testing, autoclave, and document management ensuring procedural and regulatory compliance throughout the manufacturing process. The Specialist I, Quality Assurance will report to the Associate Manager, Quality Assurance or above and will support manufacturing and quality control as the production area Quality Assurance representative.
Essential Duties and Responsibilities
* Position is on a Day Shift with occasional weekends (as needed).
* Process document control requests and issue-controlled forms, logbooks, notebooks, master production records, labels, and protocols.
* Reconcile issued controlled forms, logbooks, notebooks, master production records, and protocols.
* Coordinate and facilitate QA-related production and production-related activities.
* Review batch-related documentation and ensure resolution of issues to release product.
* Ensure that products are manufactured in compliance with site procedures, regulatory and cGMP guidelines.
* Compile and verify all batch-related documents into a final product lot disposition package.
* Communicate lot disposition pending issues to management.
* Gather metric information for use in continuous improvement of areas of responsibility. Report to management as needed.
* Work with Manufacturing and Quality Control as a production area Quality Assurance representative. Key areas of collaboration include but are not limited to; calibration and preventive maintenance, process monitoring, and inventory control monitoring.
* Support site inspections and inspection readiness activities.
* Enhance skills via regular training and continuing education, including professional society membership/participation.
* Completion of gowning qualification and maintaining status for entry into Aseptic processing area. Must be able to demonstrate a sound knowledge of aseptic gowning practices.
* Author, Approve or Authorize documents as assigned. Documents include but are not limited to: Master Production Records, Quality Control test methods/forms, etc. Authorization includes a review of the content for applicability in connection with customer audit/inspections as well as GMP compliance.
* Perform other duties as required.
Qualifications
* Minimum of a Bachelor's degree in related field and/or equivalent experience.
* Minimum of 1 year of experience in quality and/or manufacturing in a pharmaceutical, biotech, or biologics cGMP regulated manufacturing environment preferred.
* Working knowledge of quality operations and ability to apply cGMPs in conformance to U.S. standards, and where appropriate, other regulatory authority standards.
* Working knowledge of GCP, GDP, GLP and cGMP regulations and their relevant ISO counterparts and ICH Guidelines
* Thorough knowledge of aseptic manufacturing processes.
* Excellent organizational skills, attention to detail, and Good Documentation Practices.
* Proficiency in MS Word, Excel, Power Point, Microsoft Office 365 and other applications.
* Ability to communicate and work independently with scientific and/or technical personnel.
* Must possess effective interpersonal, verbal, and writing skills, patience, professionalism, and the ability to effectively interact and communicate with internal staff and management.
* Excellent organizational skills, attention to detail, and Good Documentation Practices.
* Proficiency in MS Word, Excel, Power Point, Microsoft Office 365 and other applications.
* Must possess effective interpersonal, verbal, and writing skills, patience, professionalism, and the ability to effectively interact and communicate with internal staff and management.
* Ability to thrive in a fast-paced, patient-focused manufacturing environment with minimal direction and able to adjust workload based on changing priorities.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to experience prolonged sitting, some bending, stooping, and stretching. Hand-eye coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. A normal range of hearing and vision correctable to 20/20 is required. Occasional lifting up to 20 pounds is required.
Benefits
Our values apply to how we view caring for each other as well. While the patient comes first, our employees are vital to making that happen, and so we strive to offer a competitive benefits package that includes:
* Medical insurance coverage (multiple options to meet our employees' and their families' needs)
* Dental and vision coverage
* 401k match plan
* Lifestyle spending account
* Compensation (annual): $60,500 - $77,000 (Please note that this compensation range includes base salary plus anticipated annual bonus)
Visa Sponsorship Not Currently Available
IMPORTANT: Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
$60.5k-77k yearly 35d ago
Analytics QA Tester (Remote)
Vaya Health 3.7
North Carolina jobs
LOCATION: Remote - This is a home based, virtual position that operates Monday - Friday from 8:30am-5:00pm (EST). Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.
GENERAL STATEMENT OF JOB
The Analytics QA Tester works independently, as well as with developers and business analysts, to test complex software and Business Intelligence solutions. Develop test plans, participate in peer reviews of software solutions (including code reviews), and assist end-users with user acceptance testing. Responsible for automated regression testing. Work closely with other software developers and analysts to understand what the product is meant to do, to identify issues in design and development, and to provide recommendations for improvements. Analyze and understand complex data sources in order to validate developed applications, Business Intelligence solutions, data warehouses, data visualizations, and extract, transform, and load (ETL) procedures. As a member of an agile development team this position will test new features for functionality and user experience.
ESSENTIAL JOB FUNCTIONS
Work with the Analytics Development Team to test applications and Business Intelligence products during the systems development life cycle (SDLC).
Assist end-users in performing user acceptance testing on developed solutions.
Responsible for designing and implementing test plans and test cases based on product specifications.
Perform post-implementation testing of developed solutions.
Document test plans, test cases, and test results.
KNOWLEDGE OF JOB
Integrity and decision-making skills necessary to work with and protect confidential personal health information
Problem solver, with ability to debug complex processes and applications
Analytical and troubleshooting skills
Experience within an agile development process, creating and using automating acceptance tests, automated test framework, de-bugging tools and analyzing stack traces.
Microsoft Team Foundation Server for work item tracking and source code control is preferred
Experience testing web applications, including the ability to use and understand advanced features of web browsers
Experience testing end-user reports, ETL packages, and data visualizations including the ability to test Microsoft T-SQL procedures
Excellent verbal and written communication skills, ability to articulate ideas clearly
Proven ability to meet development commitments and manage expectations
Desire for constant improvement
Ability to work independently and as a strong team player
Ability to work in a fast-paced, deadline driven environment running multiple projects simultaneously
High level of computer literacy with spreadsheets, word processing and database software and business systems (Word, Access, Excel, PowerPoint, MS Project, VISIO and other graphic software).
Extensive development, architecture, and configuration skills in Microsoft SQL Server 2008, 2012, or 2014 including strong SQL development skills (preferably Microsoft T-SQL).
Extensive development, architecture, and configuration skills with the Microsoft .NET framework including development of applications using C# or VB.NET.
EDUCATION & EXPERIENCE REQUIREMENTS
Bachelor's Degree in Computer Science, Information Technology, Engineering, or a related discipline required and 5 years of experience testing highly complex software applications crossing multiple platforms and diverse technologies.
PHYSICAL REQUIREMENTS
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.
RESIDENCY REQUIREMENT: The person in this position must live in NC, SC, GA, TN, VA, MD, or FL.
SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open until filled.
APPLY: Vaya Health accepts online applications in our Career Center, please visit ******************************************
Vaya Health is an equal opportunity employer.
$54k-67k yearly est. Auto-Apply 60d+ ago
Quality Assurance Manager
Maximus 4.3
Cincinnati, OH jobs
Description & Requirements Maximus is currently hiring for a Quality Assurance Manager to support our Missouri Enrollment Broker project. This is a full time remote opportunity. The Quality Manager is responsible for overseeing the daily operations for the Quality Assurance team, and for creating efficient business partnerships to meet business goals. The project will be a multi-channel contact center that will support multiple clients throughout the state of Missouri.
*This job is contingent upon contract award.*
At Maximus we offer a wide range of benefits to include:
- • Competitive Compensation - Quarterly bonuses based on performance included!
- • Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.
- • Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.
- • Unlimited Time Off Package - Enjoy UTO, Holidays, and sick leave,
- • Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
- • Recognition Platform - Acknowledge and appreciate outstanding employee contributions.
- • Tuition Reimbursement - Invest in your ongoing education and development.
- • Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.
- • Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.
- • Professional Development Opportunities- Participate in training programs, workshops, and conferences.
Essential Duties and Responsibilities:
- Oversee the day-to-day functions of the Quality Assurance (QA) department.
- Manage an effective quality assurance program that monitors and resolves issues before they become problems.
- Supervise the development and regular update of policies and procedures.
- Evaluate the need for and ensure the provision of necessary training for project personnel, providing up-to-date information on relevant programs, community resources, and options for consumers.
- Arrange staff training on a regular and ongoing basis. Ensure project training program meets all corporate requirements.
- Provide project leadership with updates on all issues regarding quality, operations, training, and policy and procedures.
- Provide leadership to all staff in the areas of quality improvement as it relates to process improvement, customer service and conflict resolution.
- Prepare reports and briefings for project leadership and review monthly and quarterly project status reports provided to the Department.
Minimum Requirements
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.
- Must be willing and able to travel up to 25% of the time as business need dictates.
- Lean Six Sigma experience with a minimum of Yellow Belt Certification required.
- Experience managing direct reports remotely required.
- Experience with designing, implementing and reporting customer satisfaction surveys required.
- Experience with standardized quality tools required.
- Experience with call and voice monitoring platforms required.
- Experience with a large-scale telephony system required.
- Experience with Client Relationship Management (CRM) platforms required.
- Experience with contract compliance and quality platforms required.
- Experience with statistical processes required.
- Premium contact center billing experience required.
- Financial experience with Oracle preferred.
Home Office Requirements:
- Internet speed of 20mbps or higher required (you can test this by going to *******************
- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router.
- Must currently and permanently reside in the Continental US.
#max Priority #LI-Remote
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************.
Minimum Salary
$
80,000.00
Maximum Salary
$
95,000.00
$65k-93k yearly est. Easy Apply 6d ago
QA Engineer
The IHC Group 4.4
Fairlawn, OH jobs
We are seeking a proactive QA Engineer who will work alongside business analysts, product managers, and developers to test daily development tickets, coordinate and execute User Acceptance Testing (UAT), and lead the development and maintenance of automated regression tests.
This role is critical in ensuring product quality across releases and features. You will work across manual and automated testing efforts, with a strong focus on Selenium-based test automation and supporting the team in delivering reliable, high-quality software.
ESSENTIAL DUTIES AND RESPONSIBILITIES
* Execute daily manual testing for development tickets returned for QA.
* Collaborate with analysts, developers, and stakeholders to define and write test cases based on requirements.
* Manage and coordinate UAT efforts, including obtaining stakeholder sign-off for new features and releases.
* Identify, document, and track software defects using issue-tracking systems (e.g., Jira).
* Lead the design, development, and maintenance of automated test scripts using Selenium or other automation frameworks.
* Manage and maintain the regression test suite, ensuring automated tests are regularly executed and updated.
* Work closely with development teams to understand new features and ensure test coverage.
* Participate in Agile ceremonies such as sprint planning, daily stand-ups, and retrospectives.
* Continuously improve QA processes and recommend automation and tooling enhancements.