Jobs in the United States

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Added just now
Registered Nurse
Appalachian Regional Healthcare, Inc.
Beckley, WV
Reports up chain of command Clinical Nurse Manager/Nurse Manager/House Nurse Coordinator pertinent information
Added 3 mins ago
C6
Senior Manager, Software Quality Assurance
Company 601 LivaNova USA Inc
United States
- $150,000 to $175,000 USD / year
As our Senior Manager, Software Quality Assurance, you will lead the software quality function while applying hands-on software development knowledge to ensure product software, firmware,…
Added 5 mins ago
Senior Lead Field Marketing Manager
Lumen
Jefferson City, MO
The Senior Lead Field Marketing Manager (FMM) serves as a strategic partner to Enterprise Sales, responsible for developing and executing integrated field marketing plans that accelerate…
Added 5 mins ago
Sr. Program Account Manager
Vizient, Inc.
Cape Girardeau, MO · Irving, TX
Advanced Excel, data analysis, and reporting skills with the ability to translate complex information into actionable business recommendations.
Added 10 mins ago
Senior Manager, QC Analytical-1
Devens
Devens, MA
Bristol Myers Squibb is seeking a Senior Manager for QC Analytical at the Cell Therapy Facility (CTF) in Devens, MA. This role supports the QC analytical operations team, develops and…
Added 10 mins ago
Controller
Concurrent Technologies Corporation
Johnstown, PA
Ensure optimal allocation of resources, including technology, personnel, and funding, to meet program requirements and organizational objectives.
Added 10 mins ago
Senior Principal Cyber Security Engineer Specialist
Concurrent Technologies Corporation
Columbia, MD
Advanced Security Innovation and Architecture:
Added 12 mins ago
Technical Program Manager (Consumer Experience)
Memorial Hermann Health System
United States
…elevating the patient experience across all care settings. The Program Manager plans, directs, and coordinates systemic programs that support the Consumer Experience (CX) strategy and the…
Added 12 mins ago
Manager Business Intelligence
Ascend Learning, LLC
MD · IA · AR · WI · NC · MI · NE · AL · TN · NV · WV · KS · UT · MA · TX · CA · ME · NJ · KY · AK · MO · ND · Fort Vannoy (historical), OR · MS · LA · ID · NM · Chandler, AZ · SC · IL · Minneapolis, MN · Scottsdale, AZ · MT · NH · FL · CO · OR · PA · CT · NY · DE · WA · WY · RI · OK · SD · OH · Philadelphia, PA · GA · Burlington, MA · AZ · HI · MN · VT · Gilbert, AZ · IN · VA · Leawood, KS
The Manager, Business Intelligence leads analytics strategy for Ascend Learning’s Healthcare segment, develops a team of Business Intelligence Analysts, and delivers trusted data products…
Added 12 mins ago
SA
Advanced Therapies Financial Coordinator
Shields Advanced Therapies
Durham, NC
- $55,000 to $60,000 USD / year
Advanced therapies represent one of the most significant shifts in modern healthcare, yet health systems face substantial operational, clinical, and financial barriers to adoption.
Added 12 mins ago
2027 Summer Internship Program - Configuration and Automation
CareSource Management Services LLC
Remote, United States
…vary by assignment. We offer a 12-week, paid summer internship program for college students who want to separate themselves from the pack. This is an exciting opportunity to obtain…
Added 12 mins ago
Senior Program Manager - Planning and Environment, Cooperative Research Program
National Academy of Sciences
United States
The Senior Program Manager - Planning and Environment provides senior-level program management for a complex and diverse portfolio of cooperative transportation research projects. This role…
Added 12 mins ago
Senior Program Manager - Airports
National Academy of Sciences
United States
The Senior Program Manager, Airports provides senior-level program management for a complex and diverse portfolio of airport research projects. This role has no direct supervisory…
Added 12 mins ago
Case Manager
Memorial Hermann Health System
United States
The purpose of the Case Manager position is to support the physician, primary medical homes, and interdisciplinary teams. Facilitates patient care, with the underlying objective of…
Added 13 mins ago
NB
Space Planning Manager
Neurocrine Biosciences Inc.
United States
- $119,700 to $164,000 USD / year
The Space Planning Manager is responsible for developing and leading complex workplace and space planning initiatives across the San Diego headquarters and global portfolio, providing…
Added 14 mins ago
Desktop Support Representative II
Calista Brice LLC
Fairbanks, AK
Independently diagnose and resolve hardware, software, operating system, connectivity, and endpoint issues that require advanced troubleshooting beyond routine first-level support.
Added 14 mins ago
Sr. Program Manager - Process & Systems Enablement
Nextpower LLC, USA
North Bldg, CA
The Senior Program Manager, Internal Processes & Sales Operations will develop, launch, and improve the internal processes and operational tools that support R&D and Sales Operations. This…
Added 14 mins ago
Fleet Maintenance Manager
Republic Services
Carnegie, PA
POSITION SUMMARY: The Fleet Maintenance Manager is responsible for the management of fleet equipment at one or more locations and managing a team(s) of technicians who are responsible for…
Added 14 mins ago
Nuclear Reactor Engineer (early career)
Westinghouse Electric Company
Etna, PA
Added 14 mins ago
Clinical Quality Program Manager
WellSky Corporation
Remote, United States
This job is responsible for ensuring compliance with WellSky's Utilization Management and Quality Improvement Program by serving as a clinical expert on state and federal regulations. The…
Added 14 mins ago
North America Quality Leader, Power Conversion and Storage
GE Vernova
Findlay Township, PA
GE Vernova’s Power Conversion & Storage business is a premier innovator in advanced energy conversion and storage systems. We empower utility and industrial customers by solving their most…
Added 14 mins ago
TH
Medical Technologist - Full Time
Trinity Health
Darby, PA
- Full-time
Sufficient knowledge of QC, protocol and procedures and brings exceptions immediately to manager.
Added 15 mins ago
P
Clinical Study Team Lead
Pfizer
Collegeville, PA
- $176,600 to $294,300 USD / year
…expertise to the design and conduct of trials in accordance with program and portfolio strategies for specific categories or therapeutic…
Added 15 mins ago
HW
Wound Care PRN RN Harrodsburg KY
Healogics Wound Care & Hyperbaric Services LLC
Harrodsburg, KY
- $37.78 to $47.61 USD / hour
Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging…
Added 15 mins ago
Controller
CONCURRENT TECHNOLOGIES CORPORATION
Johnstown, PA
…resources, including technology, personnel, and funding, to meet program requirements and organizational objectives. 13. Identify opportunities for process improvement and innovation to…

WellSky Corporation

Clinical Quality Program Manager

Remote, United States

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Job details

Experience: At least 4-6 years relevant work experience
Posting language: English
Posted: Nov 5, 2026

Original job description

This job is responsible for ensuring compliance with WellSky's Utilization Management and Quality Improvement Program by serving as a clinical expert on state and federal regulations. The scope of this job includes analyzing and presenting data to establish best practices across post-acute health care settings, including LTACHs, IRFs, SNFs, and Home Health facilities.

We invite you to apply today and join us in shaping the future of healthcare!

Key Responsibilities:

Facilitate activities related to performance measurement and outcomes, ensure the organization meets CMS, NCQA, and other regulatory standards, stay updated on relevant regulatory changes, and support their integration into practices.
Generate and validate reports to monitor performance across health plan contracts, ensuring accuracy and alignment with requirements.
Conduct regular audits of UM decisions, case documentation, turnaround times, and adherence to other CMS and NCQA requirements.
Understand how the UM Program is driven by the NCQA UM standards to ensure UM Program meets all NCQA requirements for accreditation.
Prepare and lead committee meetings on a monthly and quarterly basis, driven by NCQA requirements.
Prepare detailed quality reports, identify and analyze trends, and present findings to leadership with actionable recommendations.
Support implementing corrective action plans when scoring variances occur.
Support quality improvement project initiatives.
Prepare for regulatory, accreditation, and contractual audits, and contribute to the remediation and documentation of audit findings.
Perform other job duties as assigned.

Required Qualifications:

At least 4-6 years relevant work experience
Experience leading quality improvement projects and committee work.
Bachelor's Degree or equivalent work experience

Preferred Qualifications:

Active, unrestricted license: RN, PT, OT or SLP, with a bachelor’s degree in a related field or a combination of education and experience that includes pertinent clinical experience and advanced working knowledge of CMS standards and guidelines.
At minimum, 1-2 years of working knowledge of NCQA UM accreditation standards.
Must be able to prioritize, plan and handle multiple tasks and demands simultaneously, with competing deadlines.
Excellent in manipulating and sorting data for analytics and reporting.
Prior experience owning client compliance SLAs and ensuring success in meeting SLA requirements.

Job Expectations:

Willing to work additional or irregular hours as needed.
Must work in accordance with applicable security policies and procedures to safeguard company and client information.
Must be able to sit and view a computer screen for extended periods of time.
Travel approximately 10%.

# Remote

WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

Excellent medical with Rx, dental, and vision benefits
Mental Health support through EAP
Generous paid time off, plus 13 paid holidays
100% vested 401(K) retirement plans
Educational assistance up to $2500 per year

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is proud to be a drug-free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

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Skills

Regulatory compliance
CMS
Documentation
Reporting
Collaboration
Mental health

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