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Alignment Health
Overview
Review prior authorization requests for medical necessity using CMS and MCG guidelines to ensure high-quality, cost-effective care. Collaborate with providers and medical directors to process referrals and manage appeals and grievances.
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Compensation
$77,905 - $116,858 / YEAR
Posted
23 days ago
Hospital Sisters Health System
The Quality Improvement Nurse partners with clinical and interdisciplinary teams to analyze patient outcomes, identify areas for improvement, and guide the implementation of sustainable solutions to advance safe and reliable patient care. This role involves supporting system-wide quality methodologies, providing coaching and education, and ensuring alignment with regulatory readiness and organizational strategic goals.
$38 - $57 / HOUR
1 month ago
UHS
This role assists in coordinating improvement activities necessary for successful accreditation, licensing, and certifications, while also providing performance improvement and quality support for various service line initiatives. The coordinator will project manage cross-functional teams to develop and implement solutions for quality patient care and monitor action plans to ensure project goals are met.
Salary not listed
2 months ago
Frederick Health
This role involves reviewing patient records to assess the quality of care, identifying, analyzing, and implementing performance improvement activities, and collaborating with teams to develop and monitor quality indicators. The coordinator also performs retrospective and concurrent record reviews to meet national quality measures and organizational goals, while supporting the Medical Peer Review process.
$69,909 - $100,131 / YEAR
3 months ago
