Jobs in the United States

25+ jobs

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Director, GPO Strategic Accounts
LUMICERA HEALTH SERVICES LLC
MIDDLETON, WI
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Nurse Practitioner (CNP) - Primary Care Provider/Wisconsin Rapids, WI CBOC
Veterans Affairs, Veterans Health Administration
Wisconsin Rapids, WI
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Crewleader Warehouse
DEL MONTE FOODS
PLOVER, WI
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Human Resource Supervisor
DAYBREAK FOODS INC
PALMYRA, WI
…implementing best practice HR initiatives. By partnering with site leadership ensures a positive and cohesive employee experience throughout the employee lifecycle. This includes strategic…
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Microsoft Dynamics 365 & Power Platform Developer
Default - MMO
Cleveland, OH
Application Solution Development: Designs, develops, and maintains Microsoft Dynamics 365, Dataverse, and Power Platform solutions providing technical leadership, mentorship, and guidance…
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GH
Occupational Therapist (OT)
Genesis Healthcare
Wyocena, WI
- $40 to $44 USD / hour
…more. Earn rewards through our PowerZone Employee Recognition Program, and expand your expertise with our Clinicians in Action professional development…
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KD
Account Sales Manager
Keurig Dr Pepper
Prairie du Chien, WI
- $40,500 to $63,000 USD / year
Benefits, subject to election and eligibility: Medical, Dental and Vision, Paid Time Off, 401(k) program with employer match, Child & Elder Care, Adoption Benefits, Paid Parental Leave,…
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Collision Prepper
Gerber Collision & Glass
Verona, WI
A professional atmosphere, great working conditions, dynamic leadership
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Physical Therapist
US Physical Therapy
Grand Rapids, MI
Graduate or upcoming graduate degree from a CAPTE-accredited Physical Therapy program
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UP
Physical Therapist-
US Physical Therapy
Bellmore, NY
- $45 to $65 USD / hour
Leadership Development Programs- Structured leadership development programs that help you strengthen your clinical skills and gain the knowledge, support, and tools to excel as a future…
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Branch Manager 3 - Downtown Clarksville Office
U.S. Bank National Association
Clarksville, TN
…employees. This includes providing real-time feedback, fostering development, and ensuring employees are equipped to deliver exceptional customer…
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Site Reliability Engineering (SRE ) lead
U.S. Bank National Association
Gresham, OR
Provide leadership, coaching, mentoring, and workload management for SRE, DevOps, and production support engineers.
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PHYSICAL THERAPIST II, HFMH - HFM REHAB
FROEDTERT
MANITOWOC, WI
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PHYSICAL THERAPIST II, FCP - DTS REHAB P
FROEDTERT
OAK CREEK, WI
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Field Trainer Deep Foundations Union or
VEIT & COMPANY
NEW BERLIN, WI
…workforce through effective training facilitation, content development, and the creation of certification programs. This role is ideal for someone with a strong background in the deep…
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Manager Content Strategy
FRESENIUS-KABI USA LLC
PLEASANT PRAIRIE, WI
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Mechanical Engineering Co-op
Trane Technologies
La Crosse, WI
…the importance of collaboration and customer focus. Our co-op program offers candidates working toward their Bachelor's in Mechanical Engineering exposure to a variety of assignments which…
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Sr. Product Engineer
Atkore
Harvey, IL · Merrillville, IN
…product families, leads engineering execution for new product development and value engineering projects, and ensures engineering documentation, BOMs, drawings, specifications, and system…
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Water Careers Education Intern (AISD)
Trinity River Authority of Texas
Dallas, TX · Euless, TX · Arlington, TX
TRA General Office – Northern Region Planning/Development: An intern will explore a variety of topics, including TRA drinking water and wastewater systems overview, water cycle, public…
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Physician Office Supervisor
Ascension Health
Racine, WI
Support Growth & Accountability: Partner with department leadership on meaningful performance evaluations, constructive feedback, and individual development plans.
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HF
Retail Stocking Supervisor
Harbor Freight Tools
EAU CLAIRE, WI
- $19 USD / hour
Clear path to promotion & continuous leadership development
Added just now
WV
Veterinary Hospital Manager
Western Veterinary Partners
Jenks, OK
- $55,000 to $60,000 USD / year
…have prior veterinary experience and a proven background in leadership, training, and team development - paired with a business-minded approach to hospital…
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KD
Merchandiser Stocker
Keurig Dr Pepper
Oshkosh, WI
- $21.86 to $22.95 USD / hour
Benefits, subject to eligibility: Medical, Dental and Vision, Paid Time Off, 401(k) program with employer match, Child & Elder Care, Adoption Benefits, Paid Parental Leave, Fertility…
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EC
Offer Manager - Brightlayer Energy
Eaton Corporation
Menomonee Falls, WI
- $146,000 to $215,000 USD / year
The expected annual salary range for this role is $146000 - $215000 a year. This position is also eligible for a variable incentive program.
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MANAGER- QUALITY & PATIENT SAFETY
Aspirus Ironwood Hospital
Wausau, WI
As a member of the leadership team, leads a multidisciplinary quality program (including clinical quality and patient safety, infection prevention and control, performance improvement, and…

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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