Quality Improvement Specialist remote jobs - 295 jobs

PRIDE Health is seeking a travel nurse RN Clinical Document Improvement Specialist for a travel nursing job in Rochester, Minnesota. Job Description & Requirements Specialty: Clinical Document Improvement Specialist Discipline: RN Duration: 14 weeks 40 hours per week Shift: 8 hours Employment Type: Travel ***PLEASE DO NOT RESUBMIT CANDIDATE(S) IF THEY WERE SUBMITTED ON REQUEST 36045604*** Friday -Tuesday 8-5 with mandatory overtime as needed. Requirements: -CDIP or CCDS -RHIT, RHIA, RN, RRT, CCS, CCS-P, or MD required. Pre-screening questions required (answers must be thoughtful - this is their chance to sell their experience. Document attached. Candidates MUST HAVE current productivity experience (not in a current leadership role). The Inpatient Clinical Documentation Integrity (ICDI) Specialist is accountable for reviewing patient medical records in the inpatient and/or outpatient setting to capture accurate representation of the severity of illness and facilitate proper coding. Validates coding reflects medical necessity of services and facilitates appropriate coding which provides an accurate reflection and reporting of the severity of the patient's illness along with expected risk of mortality and complexity of care. Documentation of discharge diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Utilizes advanced knowledge of disease processes (pathophysiology), medications, and have critical thinking skills to analyze current documentation to identify gaps. Identifies opportunities in concurrent and retrospective inpatient clinical medical documentation to support quality and effective coding. Understands and applies regulatory compliance related to documentation, coding and billing for all health insurance plans. Facilitates appropriate modifications to documentation through extensive interactions and collaboration with physicians, coding, case management, nursing and other care givers. Serves as an effective change agent as an educator and resource for physicians and allied health staff to improve the quality and completeness of the clinical documentation. Performs all duties and responsibilities in accordance with ethical and legal business procedures, compliant with federal and state statutes and regulations, official coding rules, guidelines and accepted standards of coding practice including appropriate clinical documentation policies. This Position is 100% Remote can work from anywhere within the U.S. Pride Health Job ID #3-36474349. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About PRIDE Health PRIDE Health is the minority-owned healthcare recruitment division of Pride Global-an integrated human capital solutions and advisory firm. With our robust and abundant travel nursing and allied health employment options across the U.S., PRIDE Health will allow you to help change the way the world lives and heals as it connects you with the industry's leading healthcare organizations. Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors. Benefits Weekly pay Holiday Pay Guaranteed Hours 401k retirement plan Cancelation protection Referral bonus Medical benefits Dental benefits Vision benefits

Certification Details Certified Documentation Improvement Practitioner (CDIP) Certified Clinical Documentation Specialist (CCDS) Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Registered Nurse (RN) Registered Respiratory Therapist (RRT) Certified Coding Specialist (CCS) Certified Coding Specialist-Physician-based (CCS-P) Medical Degree (MD) Job Details The Inpatient Clinical Documentation Integrity (ICDI) Specialist is accountable for reviewing patient medical records in the inpatient and/or outpatient setting to capture accurate representation of the severity of illness and facilitate proper coding. Validates coding reflects medical necessity of services and facilitates appropriate coding which provides an accurate reflection and reporting of the severity of the patient's illness along with expected risk of mortality and complexity of care. Documentation of discharge diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Utilizes advanced knowledge of disease processes (pathophysiology), medications, and have critical thinking skills to analyze current documentation to identify gaps. Identifies opportunities in concurrent and retrospective inpatient clinical medical documentation to support quality and effective coding. Understands and applies regulatory compliance related to documentation, coding and billing for all health insurance plans. Facilitates appropriate modifications to documentation through extensive interactions and collaboration with physicians, coding, case management, nursing and other care givers. Serves as an effective change agent as an educator and resource for physicians and allied health staff to improve the quality and completeness of the clinical documentation. Performs all duties and responsibilities in accordance with ethical and legal business procedures, compliant with federal and state statutes and regulations, official coding rules, guidelines and accepted standards of coding practice including appropriate clinical documentation policies. This Position is 100% Remote can work from anywhere within the U.S. Job Requirements CDIP or CCDS certification required. RHIT, RHIA, RN, RRT, CCS, CCS-P, or MD required. Candidates MUST HAVE current productivity experience (not in a current leadership role). Two years of experience in an Inpatient Clinical Documentation Integrity Specialist (ICDIS) role, concurrent review of medical records in the field of ICDI and experience in a production role within the last 12 months. Demonstrated skills in analytical thinking, problem solving. Effective verbal and written communication including ability to present ideas and concepts effectively to physicians, management and other members of our healthcare team. Self-motivated and able to work independently without close supervision. Demonstrated ability to work well with others in a creative and challenging work environment. Must be able to work flexible hours which may include evenings and weekends as required to meet business needs. High School diploma or GED required. Schedule Information Monday to Friday, 8 AM to 5 PM with mandatory overtime as needed. Additional Details Must be able to work flexible hours which may include evenings and weekends as required to meet business needs.

Company Canon U.S.A., Inc. Requisition ID 33248 Category Administrative/Clerical Type Full-Time Workstyle Hybrid About the Role Canon is seeking an experienced Senior Government Bid Specialist to lead the preparation, coordination, and submission of competitive and compliant proposals in response to federal government solicitations (RFPs, RFIs, RFQs). The ideal candidate will have extensive knowledge of the government procurement process, strong project management skills, and the ability to develop winning strategies in collaboration with internal and external stakeholders. Your Impact Key Responsibilites: - Analyze government solicitations and manage the end-to-end bid response process. - Develop and maintain proposal schedules, outlines, compliance matrices, and response templates. - Collaborate with cross-functional teams (sales, pricing, contracts, legal, technical, etc.) to gather input and write compelling, compliant content. - Conduct final quality assurance checks to ensure submissions meet all requirements and deadlines. - Maintain and update bid libraries, templates, and past performance documentation. - Track and manage multiple simultaneous bid efforts under tight deadlines. - Interface with contracting officers and procurement officials when clarification is needed. - Provide strategic input during proposal reviews (e.g., color team reviews). - Support post-submission activities, including best-and-final offers, clarifications, and award debriefings. About You: The Skills & Expertise You Bring Bachelor's degree in a relevant field. 5 years of related experience. Experience, including three years as a Government Bid Specialist at the GMD. Must have extensive knowledge of procurement rules and regulations within the scope of his/her Bid Specialist responsibilities and be able to identify clauses missing from a solicitation. Excellent verbal and written communication skills are required as is the ability to work under pressure and adhere to all deadline requirements. Must be proficient in MS Office/Good Workspace and database applications. We are providing the anticipated base salary range for this role: $$76,150-$ 114,040 annually Company Overview About our Company - p { font-size: 18px; } Canon U.S.A., Inc., is a leading provider of consumer, business-to-business, and industrial digital imaging solutions to the United States and to Latin America and the Caribbean markets. With approximately $28.5 billion in global revenue, its parent company, Canon Inc., as of 2024 has ranked in the top-10 for U.S. patents granted for 41 consecutive years*. Canon U.S.A. is dedicated to its Kyosei philosophy of social and environmental responsibility. To learn more about Canon, visit us at ***************** and connect with us on LinkedIn at company/canonusa. Who We Are Where Talent Fosters Innovation. Do you want your next professional experience to be filled with purpose and opportunity, world-class team members, and impactful work? Driven by our mission of exceeding customer expectations with our technologies and enriching the lives of our local communities and staff, we are a phenomenal team working collaboratively toward common goals. Our employees have a strong work ethic, creativity, and a cooperative spirit. We believe in integrity, respect, empowerment, and making a difference in the communities we serve. There is a strong sense of pride in what we do individually and together as a team. Join us and discover what it means to work for a global digital imaging leader with an unparalleled reputation for quality and innovation. What We Offer You'll be joining a leader in digital imaging and innovation with an immense opportunity to make an impact and create your own rewarding career. We demonstrate commitment to our employees by offering a full range of rewards, including competitive compensation and benefits. And Even More Perks! -Employee referral bonus -Employee discounts -"Dress for Your Day" attire program (casual is welcome, based on your job function) -Volunteer opportunities to give back to our local community -Swag! A Canon welcome kit and official merch you can't get anywhere else *Based on weekly patent counts issued by United States Patent and Trademark Office. All referenced product names, and other marks, are trademarks of their respective owners. Canon U.S.A., Inc. offers a competitive compensation package including medical, dental, vision, 401(k) Savings Plan, discretionary profit sharing, discretionary success sharing, educational assistance, recognition programs, vacation, and much more. A more comprehensive list of what we have to offer is available at about-us/life-at-canon/benefits-and-compensation We comply with all applicable federal, state and local laws, regulations, orders and mandates, including those we may be required to follow as a federal government contractor/subcontractor. You must be legally authorized to work in the United States. The Company will not pursue or support visa sponsorship. All applicants must reside in the United States at the time of hire. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. If you are not reviewing this job posting on our Careers' site about-us/life-at-canon, we cannot guarantee the validity of this posting. For a list of our current postings, please visit us at about-us/life-at-canon. #CUSA Workstyle Description Hybrid - This position is full time and offers a hybrid work schedule requiring you to be in the office three days a week and an option to work from home the remainder of the week (unless a specific business need arises requiring in office attendance on other days). Note that work schedules and office reporting requirements may change from time to time based on business needs. Posting Tags #li-rb-#pm19 Need help finding the right job? We can recommend jobs specifically for you! Click here to get started.

Are you a civil engineer with a solid understanding of the bid proposal process? If you are eager to take the next step in your career with the Department of Transportation, we have an exciting opportunity that could be just what you're looking for! We are in search of a meticulous professional who can expertly manage the technical aspects of crafting high-quality proposals and contract documents for bid lettings. This role not only allows you to showcase your skills but also offers the chance to contribute significantly to important projects that shape our infrastructure. Do not miss out on the opportunity to build the career you have always wanted-apply today! DESCRIPTION OF WORK The main duty of this role is to apply engineering principles and practices to ensure that bid packages meet departmental standards and specifications while also adhering to sound engineering principles for constructability. This responsibility encompasses a thorough review of plans and associated data, as well as collaboration with designers and various district units. The position also involves the preparation of special provisions, cost estimates, and the assembly of proposal documents for federal aid projects. A significant aspect of the role is conducting plan checks on designs of varying complexity to verify their accuracy for potential bidders. Furthermore, the position includes assisting in the analysis of past contractor bids to assess their influence on future estimates, thereby enhancing the overall efficiency and effectiveness of construction projects. Work Schedule and Additional Information: Full-time employment Work hours are 7:30 AM to 3:30 PM, Monday - Friday, with a 30-minute lunch. Telework: You may have the opportunity to work from home (telework) part-time upon successful completion of probationary period. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Montoursville. The ability to telework is subject to change at any time. Additional details may be provided during the interview. Salary: Selected candidates who are new to employment within the Commonwealth of Pennsylvania will begin employment at the starting annual salary of $69,203.00 (before taxes). You will receive further communication regarding this position via email. Check your email, including spam/junk folders, for these notices. REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY QUALIFICATIONS Minimum Experience and Training Requirements: Successful completion of the Civil Engineer Trainee training program (Commonwealth job title or equivalent Federal Government job title, as determined by the Office of Administration); or Four years of civil engineering experience in the appropriate specialty, and an engineer-in-training certificate issued by or acceptable to the Pennsylvania State Registration Board for Professional Engineers, Land Surveyors and Geologists, and an associate's degree in civil engineering technology or a closely related engineering discipline; or Five years of civil engineering experience in the appropriate specialty, and an Engineer-in-Training certificate issued by or acceptable to the Pennsylvania State Registration Board for Professional Engineers, Land Surveyors and Geologists; or One year of civil engineering experience in the appropriate specialty, and a bachelor's degree in civil engineering or a closely related engineering discipline. Other Requirements: PA residency requirement is currently waived for this title. You must be able to perform essential job functions. Legal Requirements: A conditional offer of employment will require submission of criminal history reports. See hiring agency contact information. How to Apply: Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education). If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable. Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted. Failure to comply with the above application requirements may eliminate you from consideration for this position. Veterans: Pennsylvania law (51 Pa. C.S. *7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to ************************************************ and click on Veterans. Telecommunications Relay Service (TRS): 711 (hearing and speech disabilities or other individuals). If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date. The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply. EXAMINATION INFORMATION Completing the application, including all supplemental questions, serves as your exam for this position. No additional exam is required at a test center (also referred to as a written exam). Your score is based on the detailed information you provide on your application and in response to the supplemental questions. Your score is valid for this specific posting only. You must provide complete and accurate information or: your score may be lower than deserved. you may be disqualified. You may only apply/test once for this posting. Your results will be provided via email.

At Goldschmitt and Associates LLC (G&A), we're not just another company-we're a catalyst for innovation and impact, and we're inviting passionate, forward-thinking individuals to join us on this journey. Recognized multiple times on the Inc 5000 list of the fastest-growing companies, G&A is a leader in tech transformation and system modernization for some of the nation's most important federal agencies. Our culture is built on creativity and collaboration. We offer flexible schedules, telework options, and an environment where your ideas truly matter. At G&A, you won't just clock in-you'll be solving real-world challenges and working on projects that make a difference in the lives of millions. Joining our team means becoming part of a vibrant, connected community where innovation thrives, your voice is heard, and your impact is felt. Whether you're a tech enthusiast, a strategic thinker, or a problem-solver, at G&A, you'll have the opportunity to level up your career while making a real-world impact. If you're ready to be part of a company that values purpose as much as progress, G&A is the place for you! Summary: Goldschmitt and Associates is seeking an experienced Contract Specialist to provide full-lifecycle acquisition and contract administration. This position is 100% remote and supports large-scale federal design and construction projects nationwide. The Contract Specialist will possess strong federal procurement experience, excellent analytical skills, and the ability to manage multiple complex contracts simultaneously. Job Duties and Responsibilities: The Contract Specialist will perform a full range of pre-award and post-award contracting functions under the guidance and direction of a Contracting Officer. Duties include: Conduct acquisition planning and market research to determine contracting strategies and sources Prepare solicitations, Requests for Proposals (RFPs) and Requests for Quotes (RFQs), and issuing amendment Support technical evaluation panels and assist with best-value tradeoff evaluations Perform cost and price analysis, support negotiations, and prepare award documentation Process contract awards, prepare award packages, and maintain official electronic contract files Administer contracts, resolve payment issues, and prepare modifications for Contracting Officer signature Support closeout activities and ensure all documentation meets federal and agency standards Necessary Skills and Knowledge: Strong understanding of the Federal Acquisition Regulation (FAR) and agency-specific supplements Minimum Qualifications: Possess a Bachelor's degree in Business, Finance, a related field, or possess equivalent professional experience Possess at least 5 years of federal contracting experience, including experience with construction and A/E contracts Possess the ability to obtain HSPD-12 PIV credentials and pass a federal background investigation, including having residedin the United States for at least the past 3 years Preferred Qualifications: Federal Acquisition Certification in Contracting (FAC-C Professional) or DAWIA equivalent preferred Experience with PRISM, FPDS, and FBMS systems preferred NOTE: This is not intended to be an exhaustive list of all duties, responsibilities or qualifications associated with the job. It is intended to describe the general nature and work responsibilities of the position. This job description and the duties of this position are subject to change, modification and addition as deemed necessary by the Company. Goldschmitt and Associates offers the following benefits: 401(k) with immediate vesting Paid Federal Holidays Tuition Reimbursement Medical Insurance, including Vision and Dental Insurance Employer-Paid Short-Term and Long-Term Disability Employer Paid Life Insurance Supplemental Life Insurance FSA/HSA Programs Commuter Benefits Program Adoption Assistance Program Employee Assistance Program (EAP) Caregiver Support Program Health Advocacy Program Financial Wellbeing Support Goldschmitt and Associates is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

The Quality Improvement Specialist plans and executes organization-wide improvement projects in order to improve organizational performance and promote efficient use of resources through effective design, measurement and analysis of key clinical and operational processes. Applies statistical techniques, root cause analysis, Lean, Six Sigma, and other process improvement tools and techniques with subject matter experts to drive effective interventions and track the implementation of those interventions. The Quality Improvement Specialist will manage several projects simultaneously. This position is full-time remote. Selected candidate must reside in North Carolina. Occasional travel for onsite meetings at the Home office (Morrisville, NC) may be required. Responsibilities and Duties Manage interdepartmental projects to achieve quality targets- Form a team of experts required for effective completion of the project, documenting the projected resources, dates, and goals Develop and adhere to a timeline and list of tasks and resources should be generated that will describe the project in detail and plot important dates, meetings, and prospective finish Prepare and present project reports on a regular basis to the Project Team, Executives, and the Board of Directors Conduct regular meetings with team members to discuss the status of the project and also to make necessary changes and improvements to achieve the desired results Motivate and influence staff assigned to the project in order to accomplish task(s) successfully Statistics, Sociology, Economics, Public Health, Business Administration, Organizational Development, Psychology or related social science Identify and promptly address any problems that may pose a risk to achieving the desired outcome of the project within the time and budget constraints Create and deliver presentations and trainings to variety of internal and external stakeholders as needed Identify the root causes of quality issues to ensure the problem is well defined and can be addressed Leverage lean concepts to identify nonvalue-added elements and activities, and are able to use quality tools to identify failure points in processes Conduct process mapping exercises, design effective data collection plans, understand sources of performance variation, and communicate these principles effectively to a broad audience Define success targets based on internal and external requirements as well a well thought out business case Effectively measure the key output variables to ensure all performance changes are accurately assessed Conduct statistical analysis of initial and repeat measures to evaluate efficacy of interventions and to improve approach to successfully resolving root cause as needed Design appropriate sampling plans and measurement systems to assess process capability and overall system performance Evaluate validity and accuracy of data sources to draw appropriate conclusions Analyze changes in performance to determine the impacts of interventions Perform any required data analysis to evaluate performance gaps Prepare comprehensive reports to ensuring adequate documentation and methodology to support findings and recommendations Design and lead the implementation of effective interventions to drive improvement Generate and evaluate solution ideas using Lean methodologies to reduce and prevent waste Develop plans for implementing proposed improvements, including conducting pilot tests or simulations, and evaluate results to select the optimum solution Develop a sustainable monitoring process and procedure that will ensure long-term success Verify reduction in failures due to the targeted root cause Ensure that all staff involved in the improvement efforts are trained to sustain the improvements and have a robust monitoring plan to detect future performance issues Knowledge, Skills, & Abilities Advanced Project Management skills Advanced Quality Improvement Methodologies (Lean, Six Sigma, Kaizen, etc.) Advanced Data Collection & Analysis skills Advanced Microsoft Applications (Excel, Word, PowerPoint etc.) skills Advanced Communication Skills Advanced Collaboration Skills (problem-solving, mediation, conflict resolution and teamwork) Knowledge and experience with NCQA and HEDIS measurements Medicaid Experience Financial management skills Minimum Education & Experience Bachelor's degree and five (5) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research; or Master's degree and three (3) years of experience leading project teams focused on large-scale quality improvement efforts and/or experience gathering, editing, and analyzing data for social and economic research. Special Requirement Certification as a Lean practitioner and/or Six Sigma Black Belt is required within eighteen (18) months of employment Salary Range $68,227 -$86,990/ Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

Are you passionate about improving the quality of healthcare? Are you ready to leverage your talents to make healthcare better for everyone? Do you want the opportunity to give back to your community? Do you want to have fun at work ? Then join the growing team at Health Services Advisory Group (HSAG) that is transforming the delivery of healthcare in the United States! SummaryUnder supervision of the Director, the Quality Improvement Specialist (QIS) supports the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) Program by providing hands-on technical assistance and quality improvement (QI) support to healthcare providers-primarily nursing homes, hospitals, and physician practices. The QIS collaborates with providers to assess performance, conduct root cause analyses, and co-develop Quality Action Plans (QAPs) aligned with CMS priorities. This position plays a vital role in driving the adoption of evidence-based interventions, guiding providers through regulatory requirements, and helping them improve safety, care quality, and outcomes for Medicare beneficiaries through onsite visits, virtual coaching, and educational outreach. Core Competencies and Responsibilities- Provider Engagement and Relationship Management· Serve as the primary contact for assigned providers to promote participation and secure Provider Service Agreements.· Build and sustain collaborative relationships with providers and stakeholders to foster long-term engagement.· Clearly communicate complex healthcare and QI concepts via meetings, teleconferences, and written correspondence.· Refer inquiries appropriately and consult with supervisors and internal teams, when needed. QI and Technical Assistance· Apply evidence-based QI methodologies to conduct comprehensive assessments, perform root cause analyses, and deliver technical assistance aligned with CMS project goals and metrics.· Develop customized Quality Action Plans (QAPs) grounded in evidence-based interventions and recognized best practices.· Collaborate with internal teams and external stakeholders to implement effective QI interventions.· Deliver QI education, resources, and training to healthcare providers and stakeholders. Data and Reporting· Analyze clinical and operational data to identify performance gaps, interpret trends, and guide providers in implementing targeted QI strategies.· Provide tailored technical assistance through data analysis, QI coaching, and coordination of relevant resources.· Promptly and accurately document project activities, site visits, provider communications, and outcomes using HSAG and CMS-approved systems. Professional Development and Compliance· Maintain up-to-date knowledge of QI methodologies, tools, and best practices through continuous professional development.· Stay current on best-practice guidelines and regulatory updates from CMS, the Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and other regulatory agencies. Project Execution and Team Collaboration· Manage multiple initiatives, deadlines, and deliverables with strong organization and accountability.· Contribute to the development of tools, educational content, reports, and other deliverables in a team environment.· Effectively shift strategies and support approaches to align with evolving program goals, regulatory updates, and emerging challenges in the healthcare environment.· Occasionally work extended hours to meet project deadlines.Other Qualifications Working knowledge of Microsoft Office, SharePoint, or similar productivity and customer relationship management (CRM) systems is preferred. Strong written and verbal communication skills, including experience delivering presentations, conducting training, and engaging with providers via phone and email. Commitment to improving healthcare quality, safety, and outcomes for Medicare beneficiaries. Detail-oriented with strong initiative, sound judgment, and the ability to manage multiple priorities independently. Education and Experience Requirement Bachelor's degree required; Master's degree preferred. Minimum of 5 years of experience in a healthcare-related field, including QI experience. LPN or RN preferred. Work EnvironmentThe work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. DisclaimerThis is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs requiring non-regular work hours, or technological developments). HSAG is an EEO Employer of Veterans protected under Section 4212.If you have special needs and require assistance completing our employment application process, please feel free to contact us. EOE M/F/Veteran/Disability

It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Quality Improvement Outreach Specialist supports quality improvement initiatives through member-focused outreach and engagement focused on closing quality gaps in care and improving health outcomes. This role conducts proactive outreach to members for all lines of business to encourage completion of recommended preventive screenings and chronic care services. As a key member of the Quality team, this position plays a vital role in improving HEDIS, Stars and other quality measure performance and advancing overall member health through culturally competent education, coordination, and engagement. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Perform outreach calls to members with quality gaps in care · Provide education, motivational support, and scheduling assistance to help close identified care gaps and improve quality outcomes · Follow up with members requiring support in taking steps to close care gaps · Document outreach activities, tracks progress and results and supports reporting for quality campaign and initiatives · Evaluate Health Related Social Needs that may impact the member's ability to access needed services · Collaborate with internal teams to ensure coordinated member support · Meet quality and timeliness standards to achieve individual and departmental performance goals · Maintain current knowledge of quality measures and best practices · Ensure compliance with all state and federal regulations for activities performed · Participate in quality improvement activities and cross-department meetings, supporting discussions and reporting as needed · Develop and maintain policies & standard operating procedures of processes to maintain compliance · Support programs and clinical best practices with the objective of improving health outcomes, preventing hospital readmissions, and promoting health and wellness activities · Other duties as assigned Qualifications: Education Required: · Associate degree in nursing or post high school nursing diploma Education Preferred: · Bachelor's or Master's Degree in healthcare or related field Experience Required: · 2 years of experience as a practicing nurse in a hospital/healthcare setting or performing direct member outreach Experience Preferred/Desirable: · 2+ years of experience in health insurance field · 2+ years of experience in quality improvement Required Licensure, Certification or Conditions of Employment: · Successful completion of pre-employment background check Competencies, Skills, and Attributes: Required : · Strong proficiency in use of office equipment including copier, fax machine, scanner, and telephones · Strong PC proficiency in word processing, spreadsheet, and database software Preferred: · Advanced PC proficiency Professional Competencies: Required: · Effective collaborative and proven process improvement skills · Strong oral and written communication skills; ability to interact within all levels of the organization · Demonstrated commitment to excellent customer service · Knowledge and understanding of current trends in healthcare · Aptitude for aligning process, projects, and people to meet business goals in cross-functional team settings · Health care payer business knowledge including processes and operational data and functions that support the business · Maintain confidentiality and privacy · Capable of investigative and analytical research to make decisions and recommendations based on available information · Independent and sound judgment with good critical thinking skills · Knowledge of managed care, utilization management, and quality management · Establish and maintain working relationships with health care providers, members, and coworkers · Practice interpersonal and active listening skills to achieve customer satisfaction and departmental communication standards · Ability to Interpret policies, programs, and guidelines · Establish and maintain working relationships in a collaborative team environment · Organizational skills with the ability to prioritize tasks and work with multiple priorities · Maintains current knowledge of State, Federal and other applicable regulatory/accrediting agency requirements as they apply to department functions Compensation Range $74,000 - $107,000 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

The Quality Improvement Project Specialist plays a key role in supporting quality initiatives by identifying, advancing, and communicating key objectives while utilizing QI best practices and project management tools to track progress and ensure successful execution across internal and external workstreams. Reporting directly to the VP of Clinical Quality, this role requires expertise in value-based care with a particular focus on quality initiatives. The ideal candidate will act as a right hand to the VP, managing multiple deliverables and collaborating closely with both internal teams and external partners. Strong communication and stakeholder engagement skills are essential, as this position offers the opportunity to work in partnership with senior leadership and contribute to driving organizational quality goals. Primary Duties: * Aggregate and analyze data from multiple sources, to generate insights, presenting findings through reports and dashboards that highlight the potential impacts on key performance indicators and overall business objectives. * Define the optimal approach for each project including defining roles, stakeholder involvement, risk assessment, resource constraints, dependencies and expected outcomes, reviewing and approving processes, anticipating milestone dates, and adjusting throughout the course of the project to ensure alignment with quality team objectives. . * Monitor project progress, assess team capacity, and adjust as needed to maintain execution velocity, while managing multiple priorities. * Organize and lead cross-functional, quality-related project meetings. Including agenda development, scheduling, presentation preparation, documentation of notes and tracking follow-up actions. * Develop clear and compelling presentations and reports to effectively communicate quality improvement strategies and outcomes to diverse audiences. * Perform administrative tasks as directed by quality team members to support project execution and team operations Minimum Qualifications: * Bachelor's degree required * Proven ability to manage projects with excellence: successfully toward completion, coordinating and collaborating across multiple projects and teams, with foresight and timely communication * Advanced command of Excel, Google Sheets, and related data manipulation tools * Strong skills with presentation tools such as PowerPoint and Google Slides * 5+ years of work experience (preferred) * Have experience and thrive in a fast-paced environment * Willingness to travel as needed to Aledade's headquarters or markets 10-15% of the time Preferred Qualifications: * PMP certification preferred; Quality Improvement certification a plus (Lean 6 Sigma, IHI Quality Coach or Improvement Advisor, etc.) * Understanding and having experience with Tableau, Miro, Jira, Monday.com * Experience in value-based care Physical Requirements: * Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required. Who We Are: Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place. What Does This Mean for You? At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission. In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members: Flexible work schedules and the ability to work remotely are available for many roles Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners Robust time-off plan (21 days of PTO in your first year) Two paid volunteer days and 11 paid holidays 12 weeks paid parental leave for all new parents Six weeks paid sabbatical after six years of service Educational Assistant Program and Clinical Employee Reimbursement Program 401(k) with up to 4% match Stock options And much more! At Aledade, we don't just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation. Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at ************************************************* We may use automated tools, including artificial intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. Human judgment plays an essential role in our hiring process, including in the oversight and use of any automated tools. If you would like more information about our screening and hiring process, please contact us.

Job ID: R0115911 Company Name: HITACHI ENERGY USA INC Profession (Job Category): Quality Management Job Schedule: Full time Remote: Yes Job Description: The Opportunity In this role, you will be the catalyst for sustainable and transformational change across US Transformer Services. While this position offers remote flexibility, you will play a hands-on role in advancing the maturity of our Continuous Improvement Framework to ensure the high reliability of critical infrastructure. Your work involves partnering with leadership to bridge the gap between high-level strategy and daily operations, ensuring that our service value chain is safe, efficient, and responsive to the evolving needs of the power grid. By identifying waste and optimizing how we maintain and service transformer assets, you directly contribute to the stability of the energy transition and the overall productivity of our service organization. How You'll Make an Impact Steer the development and implementation of short-, medium-, and long-term actions to improve operating efficiency and quality across the entire value chain. Partner with the Services leadership team to operationalize Strategy Deployment and create a connected daily management system. Act as a change agent to foster a culture focused on waste elimination using tools like Value Stream Mapping, 5S, and Kaizen. Facilitate the integration of Health, Safety, and Environment (HSE) and Quality Management systems into the Continuous Improvement Framework. Drive the optimization of key performance indicators (KPIs) focused on Safety, Quality, Delivery, Inventory, and Cost. Research and implement Root Cause Countermeasure (RCCM) processes to resolve gaps and keep projects on track to plan. Manage a portfolio of cost-out and productivity projects, ensuring sustainable results that impact the bottom line. Build team capability by training and coaching others on Continuous Improvement Framework methods to facilitate process transformation. Responsible to ensure compliance with applicable external and internal regulations, procedures, and guidelines. Your Background Candidate must already have work authorization that would permit them to work for Hitachi Energy in the United States. Bachelor's degree in engineering or a related field. 5+ years of experience implementing and managing a Continuous Improvement Framework across an organization. Lean Six Sigma Green Belt certification with proven experience in Lean system development. Solid investigation skills and proficiency with statistical tools such as Minitab and Office software. Excellent communication and influencing skills, with the ability to collaborate with both internal personnel and external customers. Ability to travel to various office locations, job sites, or vendor locations and work in a mix of office, warehouse, and field environments as needed. More About Us Working at Hitachi Energy offers you the chance to expand your technical and organizational skills through exposure to grid technology and collaboration with industry professionals. Opportunities to work on innovative technologies that shape the future of energy A collaborative environment with experienced professionals across the power industry Access to learning platforms and career development programs Competitive health and retirement benefits Paid leave and flexible work arrangements Equal Employment Opportunity (EEO)-Females/Minorities/Protected Veterans/Individuals with Disabilities Protected veterans and qualified individuals with a disability may request a reasonable accommodation if you are unable or limited in your ability to use or access the Hitachi Energy career site as a result of your disability. You may request reasonable accommodations by completing a general inquiry form on our website. Please include your contact information and specific details about your required accommodation to support you during the job application process.This is solely for job seekers with disabilities requiring accessibility assistance or an accommodation in the job application process. Messages left for other purposes will not receive a response.

**Become a part of our caring community and help us put health first** The Quality Improvement Professional 1 will support clinicians and staff, working collaboratively with the Stars Clinical Quality RN/s, to support staffed clinical and operations teams including center administrators. Provide support, make recommendations and assist with implementing quality improvement best practice initiatives designed to improve Medicare quality measures (HEDIS), patient safety and patient experience (CAHPS-HOS). QIP assignment may be coverage of Conviva PCO staffed providers and or PCO Independent Network provider/practices functioning in a similar capacity as described previously for support to the staffed centers. + Best suited candidate will have an interest and practical experience working with clinical quality measures in particular medication adherence and HEDIS. + Utilize approved avenues to outreach to patients with medication reminders + Medical record review, retrieval, and submissions to health plans to support HEDIS gap closure. + Distribute time-sensitive and actionable data to promote action on the part of clinical teams and operations to address opportunities and close gaps (excel moderate -to- advanced skills) + Review and assess provider/member detail HEDIS data/gap reports to identify opportunities for improvement and gap closure. + Using critical thinking skills, QIP 1 leads efforts to identify opportunities for improvement, workflow deficiencies and barriers. + Provides support to provider/practice specific needs thus assisting in driving the effective implementation of the quality improvement strategy. + Manage workloads, having the ability to meet time-sensitive deadlines such as the distribution of medication adherence reports to PCP. + Train/educate teams on CMS Star measures, one-on-one or in a setting with multiple team members (clinicians, medical assistants, practice administrators, front office). + The candidate must have excellent interpersonal skills as well as the ability to develop working relationships and partnerships. Must be a "people person" since the role requires seamless teamwork to achieve targets/meet goals. + Present STARs performance information during meetings one-on-one or in wider settings. Create PowerPoint presentation. + Collaborates with various stakeholders/partners (internal and external) including market operations/provider relations, coding teams; medical directors, clinical and health plan teams, and vendors to provide support and in some cases assist with the execution of workflows developed to improve outcomes for HEDIS, patient safety (such as medication adherence) and patient experience. + Support quality initiatives eye screenings, bone mineral density, mobile mammogram etc. **Use your skills to make an impact** **Required Qualifications:** · Understanding of healthcare quality measures STARS (HEDIS, Patient Experience (CAHPS/HOS) and Patient Experience in particular knowledge of the measure technical specifications etc. · Minimum of 2 years' experience working with CMS STARs quality measures. · Prior experience in a fast-paced health care setting direct hands-on patient care, front office or provider relations field. · Experienced providing training 1:1 or in a group setting. · Ability to work independently but within team guidelines and standardized workflow. · Comprehensive knowledge of Microsoft Office Word, Excel and PowerPoint and excellent communication and presentation skills · **Must be willing and able to travel locally, to our CenterWell/Conviva Centers in and around the Houston, Texas area.** **Preferred Qualifications:** · Bachelor's or Associate's Degree · Prior LPN/LVN, Lead Medical Assistant or Center Administrator experience. · Knowledge of Humana's internal policies, procedures, and systems. **Additional Information:** · Work schedule: M-F, 8AM-5PM. Occasional after 5PM meetings · Work-at-home and visits to various medical centers and or IPA offices · Must reside in and around the Houston, Texas areas **Work At Home Statement:** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,100 - $79,900 per year **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About Us** About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

Banyan Treatment Centers is seeking a driven Compliance & Quality Specialist to support regulatory compliance, accreditation readiness, and continuous quality improvement across our behavioral health treatment programs. In this critical role, the Compliance & Quality Specialist is accountable for licensure management, regulatory adherence, performance improvement initiatives, and patient safety, while ensuring compliance with federal, state, and accrediting body standards. This role partners closely with executive leadership and interdisciplinary teams to maintain accreditation, support program expansion, and drive continuous quality improvement-making a meaningful impact in the care and safety of the patients we serve. Position Details Department: Compliance & Quality Assurance Reporting to: VP of Compliance & Quality Assurance Schedule: Full-time Location: Remote Key Responsibilities Licensure, Accreditation & Regulatory Compliance Obtain and manage federal, state, city, county, and agency facility licenses from initiation through approval. Liaise with state and county agencies to oversee licensing for all levels of care and program approvals. Monitor and track license renewals for all existing facilities and programs. Ensure compliance with Joint Commission, DCF, AHCA, CARF, and applicable federal, state, and local regulations. Implement and maintain Joint Commission standards across all Banyan companies to achieve and sustain accreditation. Policies, Procedures & Quality Improvement Edit, write, and revise policies and procedures for behavioral healthcare services. Serve as a regulatory and compliance resource for agency laws, standards, and requirements. Stay current on changes to regulations and accreditation standards, communicating updates to internal teams. Lead the development, implementation, and evaluation of annual Performance Improvement (PI) projects. Advise staff on compliance sustainability, including audit tool design, data analysis, and corrective action planning. Data, Auditing & Emergency Preparedness Manage compliance database systems, including training, system updates, and report generation. Conduct audits and analyze compliance and quality data to identify risks and improvement opportunities. Update and maintain the annual Disaster Plan and coordinate required drills and meetings. Collaborate on external benchmarking, data comparisons, and quality reporting initiatives. Participate in Compliance & Quality initiatives as directed by leadership. Qualifications Bachelor's degree in Healthcare Administration, Health Information Management, Public Health, Business Administration, or a related healthcare-focused field. In-depth knowledge of healthcare regulations and accrediting bodies, including Joint Commission, DCF, AHCA, and CARF. Demonstrated experience with auditing, data analysis, and interpreting healthcare compliance data. Working knowledge of quality improvement methodologies (PDSA, Lean, Six Sigma). Strong understanding of medical terminology and ability to collaborate effectively with clinical teams. Experience working with EHR/EMR systems and regulatory compliance software. Ability to manage multiple projects simultaneously with strong attention to detail and accuracy. Excellent communication, interpersonal, and collaboration skills. Preferred Qualifications Professional certifications such as CHC, CHPC, CCEP, CMA, PMP, CPHQ, CPHRM, or CHQ. Experience in behavioral health, mental health, detox, or acute care settings. Familiarity with KIPU EMR. Why Join Banyan Treatment Centers? This is an opportunity to make a meaningful impact within a nationally recognized leader in addiction and mental health care. As our Compliance & Quality Specialist, you will: Play a key role in ensuring patient safety, regulatory excellence, and quality outcomes. Expand your expertise in healthcare compliance, accreditation, and quality improvement. Partner with leadership to support program growth, licensure, and operational integrity. Contribute directly to Banyan's mission of delivering ethical, compassionate, high-quality care. Enjoy comprehensive benefits including medical, vision, and dental insurance; life and disability coverage; a 401(k) with employer match; paid time off and holidays; wellness incentives; and employee assistance programs. Apply Now! Ready to make a difference? Bring your compliance and quality expertise to Banyan Treatment Centers and help support safe, effective, and life-changing care. Apply today. EOE

Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet. The Quality Improvement Specialist 2 leads and directs multiple complex projects with high levels of functional and clinical integration across the UHealth enterprise. The incumbent is responsible for medium to large scale project lifecycles from request, assessment, planning, execution, monitoring and optimization. This role is expected to leverage Project/Performance Improvement (PI) principles (e.g., Lean Six Sigma, PDSA, and Industrial Engineering) and Project Management (PM) principles and tools that will have a direct impact in healthcare quality, patient safety, clinical transformation, value based care, and/or clinical variations in order to successfully design, communicate, and strategically implement healthcare quality programs and initiatives that deliver on key organizational objectives. * Leads collaborative efforts by fostering a culture of shared accountability in a high performing work group. * Assembles and leverages project teams, assigning individual responsibilities, identifying appropriate resources needed and developing a roadmap and schedule to ensure timely completion of projects. * Analyzes clinical quality data, identifies opportunities, and develops and implements action plan for quality improvement initiatives. * Delivers solutions that are systematic, scalable, incorporate business process management, incorporate advanced technology solutions, and often impact organizational culture and clinical transformation. Ensures adherence to quality and data governance standards. * Ensures recommended solutions meet the targeted business/clinical objectives, and a plan is in place to monitor sustainability of the recommendations. * Communicates from the top down and bottom up regarding the team responsibilities, target dates, project status, resource needs and provides general project communication as needed. * Fosters clear communication and synchronizes the activities of multiple projects and teams. Creates and maintains proper documentation of project related tasks and timelines. * Presents recommendations and strategies to decision makers that are systematic, scalable, incorporate business process management, incorporate technology solutions, and often impact organizational culture and clinical transformation. * Collaborates with and mentors employees in Quality Improvement Specialist 1 positions. Works closely with the Patient Safety & Quality leadership team. * Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. CORE QUALIFICATIONS Education: Bachelor's degree in relevant field Experience: Minimum 5 years of relevant experience Knowledge, Skills and Behaviors: * Ability to maintain effective interpersonal relationships * Ability to communicate effectively in both oral and written form * Skill in collecting, organizing and analyzing data * Proficiency in computer software (i.e., Microsoft Office) The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for. The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Job Status: Full time Employee Type: Staff

FirstCarbon Solutions (FCS), an ADEC Innovation, is focused on improving the world we live in. It's our goal to improve the lives of all the people we work with, whether they are clients, partners, or colleagues. Come join our team of amazing professionals dedicated to making the world a better place! An Air Quality Specialist (CG04) prepares technically sound and legally defensive air quality, greenhouse gas, and energy analyses and technical appendices, primarily for California Environmental Quality Act (CEQA) and National Environmental Policy Act (NEPA) documents, such as Initial Studies (ISs), Environmental Analyses (EAs), Environmental Impact Reports (EIRs) or Environmental Impact Statements (EISs). This role is approximately 85% report writing/analysis and 15% modeling, this role is an on-call or part-time role that can advance to a full time position. Duties and Responsibilities Provide support and assistance to Section and Project Managers in research, technical writing, and model/simulation functions, as requested, as well as provide recommendations to improve efficiency and effectiveness Develop technically and legally defensible air quality, greenhouse gas, and energy analyses and technical appendices to be included in CEQA and NEPA environmental documents Use approved software models, such as the California Emissions Estimation Model (CalEEMod) and EMFAC, to estimate a project's air pollutant emissions Develop and quantify the emission reduction potential of appropriate mitigation measures, if needed Develop either technical reports or sections for environmental documents Use air dispersion models, such as AERMOD and HARP, to evaluate the project's construction-related and operational-related emission and health impacts Develop air quality policy documents, such as air quality elements to General Plans Help develop mitigation monitoring plans and programs to ensure compliance with stated and agreed-to mitigation requirements Meet the firm's and client's goals within the agreed-upon scope of work and budget Develop and maintain mutually beneficial relationships with clients and colleagues Represent and promote the firm's strengths/reputation in the air quality industry Skills Ability to plan, organize, and coordinate air quality assessments Provide effective and quality communication through written and oral methods Work creatively as a member of an environmental assessment team Promote teamwork through interpersonal skills Marketing and proposal preparation Demonstrated proficiency in MS Office applications, especially Word and Excel, as well as internet usage Education and Experience Bachelor's degree in environmental sciences or related field required; Master's degree in Environmental Management or equivalent a plus 2-4 years of experience in Environmental Services, air quality and/or greenhouse gas emission inventory quantification, and modeling skills, including AERMOD, CalEEMod, ArcGIS, and other software models Other air permitting or assessment/modeling experiences are highly desired Work Environment The position operates in a remote, home office environment. This role routinely uses standard office equipment. This position may require some travel to attend meetings as well as fieldwork. This role may be exposed to a variety of terrains and a variety of weather conditions while performing fieldwork. Physical Demands While performing the duties of this job, the employee is regularly required to talk and listen. The employee may spend extended periods of time sitting in front of the computer. The employee must stand, stoop, walk, and reach with hands and arms and hand/finger dexterity. Specific vision abilities this job requires include close vision, distance vision, and the ability to adjust focus. Salary: $60,000 - $72,500 FCS offers competitive salaries and robust benefits with opportunities for personal and professional development. If you want to work in a collaborative, creative work environment where you can provide meaningful contributions while being challenged to grow on the job, then you are encouraged to apply! Competitive, progressive benefits including Remote/Hybrid/in-office work location options Escalating PTO structure Up to 10 paid holidays (up to 4 are flexible holidays) Full health care package: Up to 100% employer-paid employee medical and 55% eligible dependent coverage* 80% employer-paid dental and vision Employer-paid Life and AD&D insurance Short- and long-term Disability insurance Employee Assistance & Wellness Program 401k & Roth Pet insurance discounts Information Security Adhering to all policies, guidelines, and procedures pertaining to the protection of information of the organization, employees must maintain confidentiality of all sensitive information to which they are given access. They are also responsible for reporting actual or suspected events or incidents, including vulnerabilities or breaches, that may affect the confidentiality, integrity, and availability of information to members of the Management Team. Mutual respect is fundamental. Fundamental to our teams. Fundamental to our clients. Fundamental to the communities we serve and live in. Fundamental to the landscapes we work within. We need you and your unique talents, history, and background to become the Company we aspire to be. We insist upon a culture of common respect, expect transparency, and celebrate the fundamental value and dignity of all individuals. Our mutual equality as humans is the path to innovative collaboration. We cultivate integrity, driving us to growth, and allowing us to achieve more together than we could ever hope to as individuals.

We are hiring immediately for a Quality Improvement Coordinator to join the UTHealth Houston School of Public Health in Houston, TX. The Center for Health Care Data (CHCD) seeks a detail-oriented professional to support quality improvement through regulatory analysis, policy review, and technical writing. In this role, you will be responsible for reviewing managed care organization policies and procedures for compliance with federal, state, and contractual requirements, conducting document-based audits, and producing clear, well-structured executive summaries and reports for internal leadership and external stakeholders. The ideal candidate for this role should have strong technical writing skills and the ability to synthesize complex requirements. Hybrid schedule. What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in. Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus: * 100% paid medical premiums for our full-time employees * Generous time off (holidays, preventative leave day, both vacation and sick time - all of which equates to around 37-38 days per year) * The longer you stay, the more vacation you'll accrue! * Longevity Pay (Monthly payments after two years of service) * Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as... * Free financial and legal counseling * Free mental health counseling services * Gym membership discounts and access to wellness programs * Other employee discounts including entertainment, car rentals, cell phones, etc. * Resources for child and elder care * Plus many more! Position Summary: This role is responsible for reviewing managed care organization policies and procedures for compliance with federal, state, and contractual requirements, conducting document-based audits, and producing clear, well-structured executive summaries and reports for internal leadership and external stakeholders. This position emphasizes written analysis, document evaluation, and the interpretation of regulations. Position Key Accountabilities: * Performs technical writing and editing, including drafting, revising, and formatting reports, policies, and documentation to professional and regulatory standards. * Conducts structured, document-based audits of policies, procedures, and supporting documentation to assess adherence with federal, state, and contractual program requirements. * Reviews and analyzes Standard Operating Procedures (SOPs) to identify regulatory gaps, inconsistencies, and areas requiring clarification or improvement. * Prepares clear, well-organized executive summaries, audit findings, and formal reports for internal leadership, stakeholders, and state or federal regulatory entities. * Synthesizes complex regulatory requirements and audit findings into concise written guidance and recommendations for quality improvement. * Collaborates with project managers and program leadership to develop document-based quality improvement plans and track resolution of identified compliance deficiencies. * Analyzes results and program documentation to monitor adherence to regulatory and accreditation standards and to support ongoing quality assurance activities. * Supports ongoing operations by maintaining documentation, tracking actions, and assisting with follow-up reviews to ensure issues are addressed. * Interfaces with administrative, clinical, and regulatory stakeholders to clarify documentation requirements, resolve policy-related issues, and support reporting activities in a highly regulated environment. * Performs other duties as assigned. Certification/Skills: * Strong technical writing skills, the ability to synthesize complex requirements, and experience working with healthcare regulations, public health programs, public policy, and/or managed care organizations is highly preferred. * Excellent written, verbal, and presentation skills. * Ability to work independently using critical thinking skills to solve problems and improve processes. Minimum Education: * Bachelor's degree or related experience. Minimum Experience: * Three years of related experience. Physical Requirements: Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. Security Sensitive: This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4. Residency Requirement: Employees must permanently reside and work in the State of Texas.

Koniag Technology and Infrastructure Solutions, LLC, a Koniag Government Services company, is seeking a Quality Coordinator - Lead Trainer to support KTIS and our government customer. This position requires the candidate to be able to obtain a Public Trust. This is a remote position. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending accounts, paid holidays, three weeks paid time off, and more. Koniag Technology and infrastructure Solutions (KTIS) is seeking an experienced Quality Coordinator - Lead Trainer to drive our training initiatives and quality assurance programs. The ideal candidate will have a strong background in developing training materials, delivering effective training sessions, and implementing quality monitoring processes. This role is essential in ensuring our team maintains the highest standards of service excellence through continuous learning and quality improvement. **Essential Functions, Responsibilities & Duties may include, but are not limited to:** The Quality Coordinator - Lead Trainer will be responsible for developing and implementing training programs while overseeing quality assurance processes. Principal responsibilities will include but are not limited to: + Design, develop, and deliver comprehensive training programs for new and existing staff + Create and maintain training materials, including manuals, e-learning modules, and job aids + Assess training needs and develop curricula to address skill gaps and performance improvement + Lead new hire onboarding and training processes to ensure quick and effective ramp-up + Establish and maintain quality monitoring systems to evaluate employee performance + Conduct regular quality assessments through call monitoring, side-by-side observations, and performance data analysis + Provide constructive feedback to employees and develop action plans for performance improvement + Create and track key performance indicators (KPIs) related to training effectiveness and quality metrics + Collaborate with department managers to align training and quality initiatives with business objectives + Implement coaching programs to support continuous staff development + Stay current with industry best practices in training methodologies and quality assurance + Develop and maintain a knowledge repository of training resources + Coordinate with subject matter experts to ensure training content accuracy + Prepare and present regular reports on training outcomes and quality performance + Identify trends in performance issues and develop targeted training interventions **Education and Experience:** + Bachelor's degree in Education, Training and Development, Business Administration, or related field + 5-7 years of experience in training development and delivery, preferably in a contact center or customer service environment + Proven experience in quality assurance programs and performance monitoring + Background in adult learning principles and instructional design **Required Skills and Competencies:** + Strong instructional design skills with experience creating effective training materials + Excellent presentation and facilitation skills for diverse learning audiences + Knowledge of quality monitoring techniques and performance measurement + Experience with learning management systems (LMS) and e-learning platforms + Strong analytical abilities to evaluate training effectiveness and quality metrics + Excellent verbal and written communication skills + Ability to coach and mentor staff at all levels of experience + Proficiency in developing and implementing quality standards + Experience with performance management and improvement planning + Strong organizational skills and attention to detail + Ability to manage multiple projects simultaneously + Proficiency with Microsoft Office suite, particularly PowerPoint and Excel + Experience creating and delivering engaging virtual and in-person training + Understanding of adult learning theories and application + Problem-solving skills to address performance and quality issues **Desired Skills and Competencies:** + Training or quality management certifications (Certified Professional in Learning & Performance, Six Sigma, etc.) + Experience in government contracting environments + Knowledge of call center or customer service operations + Familiarity with multimedia training development tools + Experience with quality management frameworks + Background in change management methodologies + Knowledge of ITIL practices and IT service management + Experience with data analysis and statistical methods + Proficiency with video creation and editing tools + Experience with gamification in training + Knowledge of accessibility standards for training materials + Experience in contact center workforce management + Background in process improvement methodologies + Familiarity with project management principles + Experience developing training for technical subject matter **Security Requirement:** + Ability to obtain a Public Trust **Our Equal Employment Opportunity Policy** The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, ethnicity, sex, sexual orientation, gender or gender identity (except where gender is a bona fide occupational qualification), national origin or ancestry, age, disability, citizenship, military/veteran status, marital status, genetic information or any other characteristic protected by applicable federal, state, or local law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits, and all other privileges, terms, and conditions of employment. The company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or apply for a position on our website, please get in touch with Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling ************ to request accommodations. _Koniag Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions, Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag, we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical, professional, and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers, employees, and native communities. For more information, please visit_ _****************** _._ **_Equal Opportunity Employer/Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352_** **Job Details** **Job Family** **Human Resources** **Job Function** **Training/Development Specialist** **Pay Type** **Salary**

Remote, Nationwide - Seeking Data Quality Coordinator Everybody Has A Role To Play In Transforming Healthcare At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare's most pressing challenges from the inside. Join the Vituity Team. At Vituity we've cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call "culture of brilliance." Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done. Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you. The Opportunity * Serve as primary point person between Data Team and Data Acquisition to coordinate receipt of hospital files, validation, and updates to files as needed. * Develop and implement validation workflows involving cross functional teams to assess new data feeds and files to ensure accuracy and consistency between the acquired data and source systems, such as client hospital EMR systems or sources internal to the organization. * Validate data accuracy by working closely with Subject Matter Experts or Medical Directors and their Site Leadership Teams to reconcile data discrepancies and guide requests to completion. * Create training content and provide centralized guidance for cross functional team members on their roles in validation to ensure accurate reporting. * Collaborate with Data Engineering to assess data findings from quality checks and anomaly detection, conduct initial troubleshooting, and escalate problems to appropriate teams when necessary. * Work with data team to track and report on data completeness and quality metrics, including the fill rates of key data elements from source systems, and escalate for individual sources or clients when certain thresholds are met. * Document data quality issues and troubleshooting efforts as incidents and tickets in ServiceNow and/or Jira, ensuring detailed records of incidents and tracking of resolutions. * Communicate issues, blockers, or changes to data feeds to downstream parties or users and ensure timely resolution or escalation when necessary. * Continuously improve data quality standards, processes, and workflows to ensure data accuracy across sources. * Lead and participate in cross-functional data quality improvement projects aimed at enhancing the integrity of the data in the Enterprise Data Warehouse and its downstream products. * Collaborate with internal stakeholders, including Product Owners/Program Managers, Data Engineers, and Data Acquisition teams to define data quality project objectives, timelines, and deliverables. * Design and implement initiatives to automate and streamline data quality monitoring and validation processes, reducing manual effort and increasing overall efficiency. * Provide regular project updates, documentation, and outcomes to senior leadership, offering data-driven insights and recommendations for further improvements. Required Experience and Competencies * Associate's degree, or combination of education and experience that demonstrates the attainment of the requisite knowledge, skills, and abilities required. * 2+ years of experience in data quality, data analysis, quality assurance, or related roles in a healthcare setting required. * Experience collaborating with cross-functional teams and stakeholders required. * Familiarity with incident management or ticketing platforms such as ServiceNow, Zendesk, or Jira required. * Experience working with data in various formats, coordinating efforts across different teams, communicating and escalating issues, creating and driving effective and repeatable testing and approval processes, and providing validation and testing support as needed is required. * Bachelor's Degree preferred. * Experience working with hospital EMR/EHR systems such as Cerner, Epic, or Meditech preferred. * Project-based experience improving data quality or data workflows preferred. * Basic SQL skills for querying data sources or troubleshooting issues preferred. * Experience using Business Intelligence applications such as Tableau or PowerBI preferred. * Familiarity with HL7 data and feeds is a plus, with the ability to understand and work with healthcare data exchanged between systems preferred. * Excellent written and verbal communication skills, with the ability to convey complex information to both technical and non-technical audiences. * Strong analytical and problem-solving abilities and attention to detail when working with data. * Familiarity with HIPAA regulations and best practices for handling sensitive healthcare data, ensuring compliance in data validation, storage, and sharing processes. * Strong proficiency in Microsoft Excel. * Ability to navigate data in various file formats such as Excel, CSV, and TXT. The Community Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars. * Monthly wellness events and programs such as yoga, HIIT classes, and more * Trainings to help support and advance your professional growth * Team building activities such as virtual scavenger hunts and holiday celebrations * Flexible work hours * Opportunities to attend Vituity community events including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more Benefits & Beyond* Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future. * Superior health plan options * Dental, Vision, HSA/FSA, Life and AD&D coverage, and more * Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6% * Outstanding Paid Time Off: 3-4 weeks' vacation, Paid holidays, Sabbatical * Student Loan Refinancing Discounts * Professional and Career Development Program * EAP, travel assistance, and identify theft included * Wellness program * Vituity community initiatives including LGBTQ+ History, Día de los Muertos Celebration, Money Management/Money Relationship, and more * Purpose-driven culture focused on improving the lives of our patients, communities, and employees We are excited to share the base salary range for this position is $31.24 - $39.05, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company's annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details. We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us. Vituity appreciates differences; our dedication to diversity, equity and inclusion is at the heart of our organization. Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity. * Benefits for part-time and per diem vary. Please speak to a recruiter for more information. Applicants only. No agencies please.

LOCATION: Remote - preference for incumbents that live in North Carolina or within 40 miles of the NC border. This position requires travel as needed. GENERAL STATEMENT OF JOB Under the supervision of the Customer Service Quality Manager, the Quality Management Specialist resolves member and provider grievances/complaints, processes incident reports, conducts Unlicensed Alternative Living Site Reviews, assists with Home and Community Based Service (HCBS) Assessments, assists with NC Treatment Outcomes and Program Performance System (NC TOPPS) Surveys, completes any needed health/safety site visits and completes provider investigations as requested for Quality Management. The position is responsible for resolving grievances and complaints received by Vaya Health by or on behalf of any member/recipient who is dissatisfied with a Vaya contracted provider, a Vaya employee, or any aspect of Vaya or it's service delivery system. This is accomplished by processing complaint and grievance reports, coordinating resources, and communicating with all relevant parties throughout the grievance/complaint resolution process in a manner that is timely, thorough, fair, impartial, consistent, and compliant with applicable laws, rules and regulations. The position is responsible for ensuring all regulatory and accrediting guidelines/requirements are upheld throughout the resolution process. The position is responsible for reviewing incidents submitted into the Incident Response Improvement System (IRIS), Back-up staffing reports, and QM-11 reports submitted by providers in Vaya's network. The position provides technical assistance and support to ensure all reporting requirements are met related to incidents and may include document preparation, records requests and meeting facilitation. In addition, the position monitors Provider sites within the Vaya Health provider network receiving reimbursement for service provision under Medicaid, the Innovations waiver, and state funding. The position monitors the remediation of areas of non-compliance to ensure adherence to all applicable rules, regulations, and best practice models and to ensure the health and safety of persons receiving services. This position will also provide back up oversight and suport to NC TOPPS and HCBS activities when the designated primary staff person is out on leave. The position will also complete any investigations or health/safety reviews as assigned. The individual must be knowledgeable about Vaya's internal processes as well as providers, services, and stakeholders throughout the public behavioral health and intellectual/ developmental disabilities (IDD) system. ESSENTIAL JOB FUNCTIONS Grievance, Complaint, Incident, Health & Safety Response and Reviews: This position will support Provider Quality Operations and Customer Service Quality. Support of these operations may be accomplished through various activities like those listed below, and although day to day work may include activities related to these items this is not a limited list. At the manager's and director's discretion activities may be divided among the incumbents which may lead to some incumbents completing some of these tasks more than others, but all incumbents must be cross trained and able to complete all items. Activities may include, but are not limited to: Member/Recipient/Provider Grievance/Complaint Resolution The incumbent is responsible for managing assigned complaints and grievances by ensuring the concern of the individual is properly acknowledged, documented, and addressed to work toward informal resolution by: Answering questions from members, recipients, stakeholders, or others about the complaint/grievance process Timely resolving complaints and grievances through the following activities: Phone interviews with the filer and person(s) who have a legitimate role in the issue to be resolved (i.e. staff, legal guardians, providers, care managers, etc.). to obtain additional information or clarification; Consultation with Vaya staff, licensed clinicians, and subject matter experts Provider record/information request and record review Maintain timely responses to inquiries regarding grievances and complaints Provide recommendations and direction to both service providers and members in an attempt to eliminate repeated grievances of a similar nature Provide feedback to providers regarding written responses to grievances and complaints Recognize grievances and complaints that include health and safety issues that need to be immediately addressed by accurately depicting the situation in a case staffing to the CMO Recognize health and safety issues may require investigation including; but not limited to, an on-site review to ensure any Vaya members in service locations are safe. Incident Report Review, Tracking and Technical Assistance The incumbent reviews incident reports from all Vaya provider agencies within the catchment area and incident reports from provider agencies that have Vaya enrollees who receive services outside Vaya's catchment area. IRIS is a mandated electronic system for provider and LME/MCO to document the occurrence of Level II and III incidents. Incident review and response includes the following: Ensure the incident report is complete and has accurate information, request any additional or missing information Evaluate the cause/prevention section and provide technical assistance to the provider when standards for future prevention are not met Evaluate the likeliness that the incident will be in the media and alert the CMO Tracking and trending of incidents; report any trends of concern to CIRC. In addition, this position is also responsible for completing the following incident report related activities: Track and trend back-up staffing reports and compile and prepare data for quarterly reporting as needed Track and trend QM-11 (level 1 incident) reports Health/Safety Reviews including any Site Review Monitoring activities for AFL Site Reviews Use a standardized tool (checklist) for initial AFL site reviews and annually thereafter Ensure the site has met HCBS standards and approval Medication review Review the site for Health and Safety concerns that are specific to the member/recipient Inform/educate the Provider about Vaya procedures for monitoring of existing and new AFL homes Completion and delivery of all written findings to the Provider, and follow up on all deficiencies Assess sites for health/safety when required from grievances/complaints as part of investigations Investigations: Assisting with On site investigations completed by any Quality Management Team Complete assigned investigations related to grievances/complaints or health/safety requests Complete Report of Findings Complete Plans of Correction for Out of Compliance noted in Report of Findings Communicate with Providers related to investigation and outcomes Communicate with grievant/complainant/stakeholders as required for investigations Additional Tasks: Provide Backup to HCBS Provider Self-Assessment Review and Approval Process including: Upon submission, process and ensure Provider Self-Assessments are complete, accurate and meet criteria for HCBS standards, provide information and technical assistance to providers in response to incorrect or missing information. Provide Back up to NC TOPPS Activities to comply with state requirements including: Respond to NC TOPPS email inquiries, answer questions from providers or provider staff about NC TOPPS requirements, provide technical assistance to providers or provider staff on NC TOPPS. KNOWLEDGE OF JOB Ability to develop practical, thorough, and creative solutions to complex problems Ability to conduct data analysis and recognize trends is essential Ability to effectively communicate trends within Vaya to address potentially serious issues is required Ability to actively listen to grievances and complaints while maintaining a positive outlook and attitude with members, co-workers, and stakeholders Ability to work remotely (from home) with little supervision and function as a self-starter Flexible worker who readily accepts assigned tasks, manages unfamiliar situations, and searches for every opportunity to help the team Excellent time management skills, including the ability to manage competing priorities and to complete tasks in a timely and accurate manner Highly productive and motivated individual who takes pride in a job well done, demonstrates initiative and is committed to self-accountability Strong attention to detail and extreme precision and accuracy Ability to work collaboratively with individuals at all levels and with varying backgrounds both within and outside of Vaya and build strong working relationships Strong organizational skills with the ability to multi-task Ability to manage constant transformation and adapt to changing mandates from regulatory authorities as well as Vaya executive leadership Ability to maintain the confidentiality of sensitive information in accordance with applicable laws, policies, rules and regulations Ability to problem-solve and provide practical, thorough, and creative solutions to work tasks Ability to learn, interpret independently, and apply a variety of complex policies and procedures Good working knowledge and proficiency in Adobe and Microsoft Office 365 products (Word, Excel, Outlook, PowerPoint, Teams, Visio, SharePoint, etc.) Familiarity with Navex software products (PolicyTech, EthicsPoint) a plus Thorough knowledge of how to use standard office equipment, including printers, scanners, and fax machines Knowledge of North Carolina's public behavioral health and I/DD system, including Vaya providers, services, and stakeholders, preferred Ability to work independently is essential Ability to research multiple Electronic Records Systems -Ability to understand claims data Ability to understand both physical and behavioral health diagnoses Ability to synthesize information gathered in the grievance process to write a succinct resolution letter Ability to interact with team while performing grievance resolution lead duties in a respectful manner Ability to use critical thinking skills, work independently with little or no direction, demonstrate initiative, and function as a self-starter Ability to develop practical, thorough, and creative solutions to complex problems EDUCATION & EXPERIENCE REQUIREMENTS High school diploma or GED required. Bachelor's degree in a Human Services field preferred. Must have A minimum of two years of experience in quality management, data collection and analysis is required, preferably within a behavioral health organization OR a minimum of two years of experience providing care and/or customer service in an acute care, physical health, physician and/or hospital setting. The Tailored Plan does not require NC Residency for this role; however, it is the preference of Vaya and the Quality Management department that incumbents of this role fall within the guidelines of NC Residency Requirement per the Tailored Plan and reside in North Carolina or resides within 40 miles of the North Carolina border. Preferred work experience: Meeting the requirements of being a Qualified Professional per 10A NCAC 27G .0104 preferred. Preferred licensure/certification: National Certified Investigator & Inspector Training and Certification is preferred. 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: Prefer incumbent reside in North Carolina or within 40 miles of the North Carolina border. SALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is 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.

Department: 13244 Enterprise Revenue Cycle - Facility Coding Quality Integrity Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Inpatient experience desired. Remote Pay Range $28.05 - $42.10 Major Responsibilities: Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition. Ensure accurate coding for outpatient, day surgery and inpatient records. Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions. Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes. Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed. Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded. Reviews encounters flagged for second level review, including but not limited to; hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership. Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment. Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process. Review accounts with mismatched DRG assignment following notification from the Inpatient coder. Determine the appropriate DRG based on coding guidelines. Provide follow up to the clinical documentation nurse with rationale on final outcome. Recommends educational topics for coders and clinical documentation nurses based on their observations from reviewing mismatches. Participate in hospital coding denial and appeal processes as directed. Ensure timely review and response to any third-party payer notification of claims where codes are denied. Determine if an appeal will be written based on application of coding guidelines and provider documentation. Following review of overpayment or underpayment denials, provide appropriate follow-up to coding team member as appropriate, rebilling accounts to ensure appropriate reimbursement. All trends identified should be presented to coding leadership in a timely manner and logged for historical tracking purposes. Investigates and resolves all edits or inquiries from the billing office or patient accounts, to prevent any delay in claim submission due to open questions related to coding. Identifies any coding issues as they relate to coding practices. Clarifies changes in coding guidance or coding educational materials. Maintains continuing education credits and credentials by keeping abreast of current knowledge trends, legislative issues and/or technology in Health Information Management through internal and external seminars. Identify opportunities for continuing education for hospital coding team. Licensure, Registration, and/or Certification Required: Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA), or Education Required: Associate's Degree in Health Information Management or related field. Experience Required: Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions. Knowledge, Skills & Abilities Required: Demonstrated leadership skills and abilities. Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions. Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups) Advanced knowledge in Microsoft Applications, including but not limited to; Excel, Word, PowerPoint, Teams. Advanced knowledge and understanding of anatomy and physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology.) Advanced knowledge of pharmacology indications for drug usage and related adverse reactions. Expert knowledge of coding work flow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems. Excellent communication and reading comprehension skills. Demonstrated analytical aptitude, with a high attention to detail and accuracy. Ability to take initiative and work collaboratively with others. Experience with remote work force operations required. Strong sense of ethics. Physical Requirements and Working Conditions: Exposed to a normal office environment. Must be able to sit for extended periods of time. Must be able to continuously concentrate. Position may be required to travel to other sites; therefore, may be exposed to road and weather hazards. Operates all equipment necessary to perform the job. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. #REMOTE #LI-Remote Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.