Jobs in the United States

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Added 6 mins ago
A
Batcher
Aerotek
Hampton, VA
- $19 to $21 USD / hour
…Operator, Forklift Operator, Material Handler, or Manufacturing Associate, this could be the next step in your career! Batching Specialists Manufacturing Associates Liquid Processing…
Added 6 mins ago
A
Shipping/Packing Associate
Aerotek
Oklahoma City, OK
- $15 to $15.5 USD / hour
subject to specific elections, plan, or program terms. If eligible, the benefits
Added 11 mins ago
MRI Technologist
Team Member Services
United States
1+ years experience in radiology and completion of MRI training program Preferred
Added 11 mins ago
TM
Registered Nurse RN Emergency Department Full-time Nights
Team Member Services
United States
- Full-time
…salary increases of up to 20%* through our Clinical Ladder Program based on experience, professional development, and achievement of advancement…
Added 12 mins ago
Sales Associate
Carter's
Buford, GA
Added 14 mins ago
Human Resources Generalist
SK FOOD GROUP
Groveport, OH
…and hiring, leave of absence management, timecard oversight, associate relations and investigations, and other direct support of the…
Added 14 mins ago
Sr. Human Resources Generalist
SK FOOD GROUP
Cleveland, TN
Perform advanced Associate Relations functions for SK Food Group leadership, efficiently investigating and resolving complex personnel issues including harassment allegations and workplace…
Added 14 mins ago
Ophthalmologist - Greenville, North Carolina
Commonwealth Medical Services
Greenville, NC
A growing ophthalmology program is seeking a Board Certified or Board Eligible, fellowship-trained Cornea/External Disease specialist to join an expanding multi-specialty ophthalmology…
Added 14 mins ago
Pediatric Neurologist - Greenville, North Carolina
Commonwealth Medical Services
Greenville, NC
A growing neurology program in Greenville, North Carolina is seeking a Board Eligible or Board Certified Pediatric Neurologist to join an established pediatric neurology practice. This…
Added 14 mins ago
Pediatric Ophthalmologist - Greenville, North Carolina
Commonwealth Medical Services
Greenville, NC
A growing Pediatric Ophthalmology program in Eastern North Carolina is seeking a mission-driven, visionary Pediatric Ophthalmologist to join and help advance a developing academic division.…
Added 15 mins ago
Glaucoma Specialist - Greenville, North Carolina
Commonwealth Medical Services
Greenville, NC
A growing ophthalmology program is seeking a full-time, Board Certified or Board Eligible, fellowship-trained Glaucoma Specialist to join an expanding multi-specialty ophthalmology practice…
Added 15 mins ago
Dental Hygienist Ohio
Commonwealth Medical Services
Dayton, OH
Associate's degree or higher in dental hygiene from an accredited program.
Added 15 mins ago
CF
Warehouse Associate
Community FoodBank of New Jersey
Egg Harbor Township, NJ
- $23 to $31 USD / hour
As a Warehouse Associate, you will move in-bound and out-bound products to appropriate staging and/or storage areas as directed, in accordance with CFBNJ safety procedures.
Added 15 mins ago
CF
Warehouse Clerical Associate
Community FoodBank of New Jersey
Egg Harbor Township, NJ
- $23 to $31 USD / hour
As a Warehouse Clerical Associate, you will move in-bound and out-bound products to appropriate staging and/or storage areas as directed, in accordance with CFBNJ safety procedures. You…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 17 mins ago
Customer Service Representative
CK Circle K Stores Inc.
United States
You will greet customers, run the register, cashier, make purchase suggestions and sometimes work with our food program. There is never a dull moment as you will be working around the store…
Added 20 mins ago
A
Retail Sales Associate – Part Time
AutoZone
Austin, TX
- Part-time
Join our team as a Retail Sales Associate, where you'll play a key role in delivering WOW! Customer Service by exceeding expectations and making a real difference for our customers. Whether…
Added 25 mins ago
BC
Retail Janitor
Bi-Mart Corporation
Lebanon, OR
- $16.1 to $19.25 USD / hour
Previous experience as a cashier, sales associate, custodian, housekeeper, or other retail and cleaning positions are a plus.
Added 30 mins ago
Industrial Electrician - Petoskey Area
The Pivot Group Network
Petoskey · Petoskey, MI
Completed electrical apprenticeship or technical training program.
Added 30 mins ago
Parole and Probation Officer
State of North Dakota
Grand Forks, ND
Must attend the first available basic peace officer training program recognized by the North Dakota Peace Officer Standards and Training (POST) Board to obtain authorization to perform the…

AmeriHealth Caritas Health Plan

Director Quality Management

Philadelphia, PA, United States

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Job details

Education: Bachelor’s degree
Posting language: English
Posted: Nov 6, 2026

Original job description

Role Overview: The primary purpose of the job is to be responsible and accountable for the successful, ongoing development, refinement, implementation, measurement, ongoing quality improvement and effectiveness of Long Term Services & Support (LTSS).

Work Arrangement:

Remote - This posiiton is fully remote, and the Associate must be in Pennsylvania (PA)
Travel to state & leadership meeting as needed.
Reliable high‑speed internet required (minimum 50 Mbps download / 5 Mbps upload)
Associates residing in states where reimbursement is required by contract, law, or regulation may submit eligible expenses for reimbursement

Responsibilities:

Overseeing quality management for Long Term Services and Supports (LTSS) in PA
Accountable for ongoing maintenance of the Plan’s compliance with state regulations and National Committee for Quality Assurance (NCQA)/Utilization Review Accreditation Commission (URAC) and other appropriate standards for activities related to Quality, Care Management and Utilization Management.
This includes credentialing/re-credentialing activity, delegation oversight, quality of care investigations as well as the corresponding inter- and intra-departmental coordination, communication, and education.
Oversight and responsibility for the Plan’s, Line of Business or Product Line’s QAPIC Committee structure and support.
Works directly with Senior Executives to plan, organize and direct the identification, prioritization and implementation of strategic projects that improve financial, service and clinical outcomes for the Plan, LOB or Product Line.
In coordination with Plan stakeholders, develop, implement and lead strategy to improve HEDIS outcomes and maximize pay for performance payout and reduce withholds and/or liquidated damages
Provides functional support to the Network Management, Informatics, Information Solutions, Care Coordination, Utilization Management, and Public Affairs departments to integrate Quality Management initiatives and goals with organizational programs.

Education & Experience:

Bachelor’s degree required
An active unrestricted licensed Registered Nurse (RN) in PA or healthcare quality certification such as American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or Certified Professional in Healthcare Quality (CPHQ) in accordance with state specific requirements
1 to 3 years of experience in Medicaid.
5 to 10 years of experience in a clinical setting
5 or more years of experience in managed care and leadership.
Prior URAC or NCQA Accreditation experience

Skills & Abilities:

Strong leadership and people-management skills, with the ability to supervise, coach, develop, and provide performance feedback to quality management staff.
Extensive knowledge of healthcare quality assurance, quality improvement, outcomes management, and performance improvement principles and practices.
Ability to develop and present comprehensive quality reports, analyses, recommendations, and performance findings to leadership and cross-functional stakeholders.
Strong project and program management skills, with the ability to manage multiple quality initiatives, priorities, deadlines, and contractual deliverables.
Excellent verbal and written communication skills, with the ability to communicate effectively with internal teams, leadership, providers, and external stakeholders.
Strong presentation and facilitation skills, including the ability to communicate complex quality and clinical information clearly to varied audiences.
Demonstrated problem-solving, critical-thinking, and independent decision-making skills.
Ability to identify opportunities for process improvement and lead the development and implementation of improved clinical and administrative processes.
Strong interpersonal and conflict-resolution skills, with the ability to effectively manage difficult or sensitive situations.
Ability to collaborate across departments and build strong working relationships to support organization-wide quality improvement initiatives.
Strong organizational and time-management skills with excellent attention to detail.
Proficiency with Microsoft Office applications and the ability to effectively use technology for reporting, data analysis, documentation, and communication.

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