Jobs in the United States

25+ jobs

Save this search

Added just now
Human Resource Supervisor
DAYBREAK FOODS INC
PALMYRA, WI
…Partnership: Develop relationships and provide HR Business Partner support to site leadership team with particular focus on driving the site talent strategy, including coaching on employee…
Added just now
Microsoft Dynamics 365 & Power Platform Developer
Default - MMO
Cleveland, OH
…applications, and enterprise data platforms. Establish and support CI/CD pipelines, release management processes, and ALM best practices using Azure DevOps and Power Platform Build…
Added just now
Site Reliability Engineering (SRE ) lead
U.S. Bank National Association
Gresham, OR
- Six to eight years of relevant work experience in business and risk analysis, IT Service Management, production support, product/project management, or application development
Added just now
CRE Sr Underwriter
U.S. Bank National Association
New York, NY
Support both existing property transactions (including refinancings) and ground‑up construction projects, including budget monitoring and monthly construction draw reviews through project…
Added just now
Public & Labor Proposal Associate
CVS Health
Remote, United States
2+ years in sales, sales support or project management experience.
Added just now
Maintenance Engineering Supervisor
PepsiCo
Indianapolis, IN
In addition to salary, PepsiCo offers a comprehensive benefits package to support our employees and their families, subject to elections and eligibility: Medical, Dental, Vision,…
Added just now
Manager Content Strategy
FRESENIUS-KABI USA LLC
PLEASANT PRAIRIE, WI
Added just now
Sr. Product Engineer
Atkore
Harvey, IL · Merrillville, IN
Partner with Product Management, Sales, Application Engineering, Codes & Standards, and customers to answer technical questions and support product positioning.
Added just now
WV
Veterinary Hospital Manager
Western Veterinary Partners
Jenks, OK
- $55,000 to $60,000 USD / year
Project & Facility Management: Lead day-to-day operations, scheduling, and maintenance while aligning administrative functions with overall hospital objectives.
Added just now
MANAGER- QUALITY & PATIENT SAFETY
Aspirus Ironwood Hospital
Wausau, WI
Demonstrates basic strategic planning, project management, organizational development, and business skills.
Added just now
Senior Clinical Program Manager, Cardiovascular and Interventional Solutions
GE HealthCare
Waukesha, WI
We are seeking an experienced Senior Clinical Program Manager to lead research execution across GE HealthCare’s strategic cardiology partnerships and growing interventional research…
Added just now
Environmental Program Leader – Hazardous Waste and Dangerous Goods Compliance
GE Aerospace
Waukesha, WI
The Environmental Program Leader – Hazardous Waste and Dangerous Goods Compliance will provide enterprise leadership, technical expertise, and continuous improvement across hazardous waste…
Added just now
Principal Aftermarket Technical Product Manager
GE Aerospace
Waukesha, WI
Ability to document, plan, market, and execute programs. Established project management skills.
Added just now
Director, Clinical Pharmacology
Bausch + Lomb
Madison, WI
Experience across a range of development phases (discovery support through Phase 3 and life-cycle management); experience with 505(b)(2), A
Added just now
Clinical AI Technical Integration Specialist
GovCIO
Madison, WI
Route tickets and technical findings to appropriate escalation teams including Scribe support teams, ESD, OCTO shared services, and program leadership.
Added just now
W
PROGRAM SPECIALIST- 1 Year Project
WHEDA
MADISON, WI
- $57,645 USD / year
Added just now
Senior Professional, CenterWell B2B Marketing
Humana
Madison, WI
Strong project and program management skills, with demonstrated ability to manage multiple concurrent priorities, timelines, deliverables, and stakeholders in a fast-paced environment.
Added just now
Project Manager 4 (Project Manager/SRE)
GovCIO
Madison, WI
GovCIO is currently hiring a Project Manager to support the VA experience to support the Department of Veterans Affairs (VA) Project Management team to oversee the day to day operations,…
Added just now
AT
Senior Technical Program Manager
Akamai Technologies, Inc.
Madison, WI
- $119,600 to $215,400 USD / year
As a Senior Technical Program Manager, you will require technical understanding of AI/ML systems, exceptional organizational and program management skills, and proven experience leading…
Added just now
C
Customer Service Agent - Remote (Mesa, AZ)
Cognizant
Madison, WI
- $20 USD / hour
…brokers and institutional clients for the various clients that we support; you will make an impact by providing superior customer service to all clientele (both internal and external). A…
Added just now
Sr Technology Project Manager- Vulnerability and Product Support Team - Remote
SitusAMC
Madison, WI
Project management qualification (PMP), Certified Associate in Project Management (CAPM) preferred
Added just now
Manager Strategic Risk Adjustment Programs
Highmark Health
Madison, WI
This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries…
Added just now
C
Delivery Manager, Healthcare Payer
Cognizant
Madison, WI
- $130,000 to $153,000 USD / year
Lead end-to-end delivery of healthcare payer transformation initiatives, ensuring alignment with business objectives, program goals, and client expectations.
Added just now
Network Operations Engineer
Meta
Madison, WI
…cabling, fiber connectivity solutions, and IP networking to support the delivery of field repair services. You will work closely with internal business teams, external vendors, network…
Added just now
Principal Portfolio Manager, Infrastructure Development
Meta
Madison, WI
…approval, closing, and delivery readiness, and for building the program execution, governance, external partnership management, and cross-functional coordination needed to deliver billions…

Amerihealth Caritas

Director Quality Management

Philadelphia, PA, United States

Apply About employer

Applications open in a new tab.

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.

Apply About employer

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

Report this job