Remote Jobs

Quality Improvement Specialist


Pay$24.72 - $35.85 / hour
LocationFountain Valley/California
Employment typeFull-Time

This job is now closed

  • Job Description

      Req#: MEM008122
      Employer Industry: Healthcare Services

      Why Consider this Job Opportunity:
      - Competitive pay up to $35.85/hr
      - Opportunity for career advancement and growth within the organization
      - Remote work available with occasional on-site meetings
      - Supportive work environment focused on professional development and collaboration
      - High-quality health insurance plan options for employees and their dependents

      What to Expect (Job Responsibilities):
      - Support QI Nurses, QI Supervisor, QI Manager, QI Director, and others within the QI Department
      - Ensure regulatory compliance standards for Pre-service member denial letters are met consistently
      - Support the Quality Improvement Program by delegating grievances and appeals, managing Livanta Appeals, and completing member pre-service denial letters
      - Maintain department compliance with all federal, state, local laws, regulations, and organizational policies and procedures
      - Perform other duties as assigned

      What is Required (Qualifications):
      - Health Care Administrative background required
      - Strong interpersonal communication, customer service, and organizational skills
      - Strong reading and writing skills (grammar & punctuation)
      - Computer proficiency in Microsoft Office: Outlook, Word, Excel, Power Point, and Adobe Acrobat
      - Knowledgeable of medical terminology

      How to Stand Out (Preferred Qualifications):
      - Experience in Managed Care and/or Quality Improvement/Appeals & Grievances
      - EPIC (electronic medical record) experience

      #HealthcareServices #QualityImprovement #RemoteWork #CareerGrowth #CompetitivePay

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      We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.
  • About the company

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