Jobs in the United States

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Added 2 mins ago
Assistant Director of Service and Community Living
University of South Carolina
SC
…Salkehatchie, Union, Lancaster and Sumter enable students to earn associate or bachelor’s degrees through a combination of in-person, online or blended learning. All of our system…
Added 2 mins ago
Manufacturing Training Instructor | ACA
AFL Telecommunications
Duncan, SC
High School Diploma or equivalent required. Associate's or technical degree preferred.
Added 2 mins ago
H
Pre-Analytical Supervisor
Helix
United States
- $47 to $60 USD / hour
…Medical Technology, or a closely related scientific field. An associate degree with significant relevant experience will also be…
Added 3 mins ago
Senior Decision Intelligence Engineer
Humana
Dover, DE
Proficiency in Python 3.x; experience with PyTorch or TensorFlow for policy network or learned model implementation.
Added 3 mins ago
Talent Acquisition Operations Team Lead, Associate - Americas
BlackRock
Wilmington, DE
A track record of leading or supporting business transformation, process improvement, or technology implementation initiatives
Added 3 mins ago
A
Certified Occupational Therapy Assistant (COTA)
adecco
Phoenix, AZ
- $55,000 to $65,000 USD / year
Support the development and implementation of Individualized Education Programs (IEPs)
Added 4 mins ago
Associate DMS Applications Engineer
Open Systems International, Inc.
Medina, MN
…ability to monitor, manage, control, and optimize the grid. As an Associate Distribution Management System (DMS) Application Engineer you will be involved in all aspects of the successful…
Added 6 mins ago
ML
Associate Document Compliance Specialist
Mesa Labs
Bozeman, MT
- $27.64 to $34.49 USD / hour
The Associate Document Compliance Specialist supports the management and oversight of document compliance activities within the organization. Ensures that all documentation processes align…
Added 6 mins ago
Associate Director Cut-Out │ Corporate (Springdale, AR)
Tyson Sales and Distribution, Inc.
Springdale, AR
Manage plant profitability for an assigned group of fresh production facilities, including plan development, analysis, implementation, and performance management.
Added 7 mins ago
Clearable Data Center Technician, Data Center Operations
Amazon Data Services, Inc.
Aurora, CO
- Maintain service level agreements through the implementation of proactive issue detection and reporting
Added 7 mins ago
Sr. Manager - Projects and Engineering 4D
Genpact LLC
United States
Project Delivery Manage end-to-end D365 F&O implementation and upgrade projects, defining scope, timelines, and deliverables while tracking risks, dependencies, and progress.
Added 7 mins ago
CRA I - Sponsor Dedicated | Oncology / Neurology (Home-Based - Cleveland / Columbus, OH)
Syneos Health, LLC
Remote, United States
May act as primary liaison with project site personnel, or in collaboration with another CRA or Central Monitoring Associate (CMA). Ensures all assigned sites and project-specific site team…
Added 8 mins ago
RN-Wound Center
Sheltering Arms Hospital Fdn
United States
…essential functions to be performed by associates in this job. Associate is expected to all perform other duties as requested by…
Added 8 mins ago
IT Tech Lead -Revenue Cycle Applications
OhioHealth Corporation
WORK AT HOME, OH
- Oversees, or consults on, technology implementation and modification activities (for example, projects and products), particularly for new or shared solutions.
Added 8 mins ago
Staff RN- Cardiovascular Intermediate - Doctors
OhioHealth Corporation
United States
Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team,…
Added 8 mins ago
Staff RN - Riverside, MICU1, Nights
OhioHealth Corporation
United States
Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team,…
Added 8 mins ago
Senior Business Systems Engineer
NFP Corp
Windsor, CT
· Develop and maintain documentation for system design, implementation, and maintenance.
Added 8 mins ago
Director of Operations
ML Property Group LLC
Charlotte, NC
…process, budget completion and adherence process, customer and associate experience, and unit availability and product…
Added 10 mins ago
Director
Learning Care Group
Hockessin, DE
…developing performance improvement plans. Assists with the implementation of Company-provided curriculum, which includes coaching, communicating, and interpreting standards with…
Added 10 mins ago
Clinical Applications Specialist- Cardiovascular Ultrasound
GE HealthCare
Remote, United States
…experience and commercial teams from pre-sale through post implementation by providing effective outcome-based education and training…
Added 10 mins ago
Shift Supervisor
EAGLE FLEXIBLE PACKAGING
WAUPUN, WI
Added 10 mins ago
REGISTERED NURSE - MEDICAL PEDIATRICS
Aspirus Ironwood Hospital
Antigo, WI
…and accountability for the provision of assessment, planning, implementation, and evaluation of nursing care provided that incorporates evidence-based practice. A key aspect of the work of…
Added 11 mins ago
Marketing Coordinator Senior
GSS Geisinger System Services
Remote, United States
Responsible for the implementation and evaluation of marketing and communication plans and activities. These include but are not limited to advertising, digital engagement campaigns,…
Added 11 mins ago
Tooling Manager
ARIENSCO
BRILLION, WI
Added 11 mins ago
A
Clinical Laboratory Scientist I
Abbott
Marshfield, WI
- $20.5 to $41 USD / hour
Participate in the testing, validation, and implementation of new laboratory equipment and procedures.

Amerihealth Caritas

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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More about this job

Skills

Quality assurance procedures
Leadership
Regulatory compliance
Quality assurance
Communication skills
Prioritization
Network administration
RN
Team leadership
Provide performance feedback
Program management
Problem solving
Critical thinking
Decision making
Process improvement
Conflict resolution
Time management
Attention to detail
Microsoft Office
Reporting
Data analysis
Documentation

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