Quality Coordinator

1 week ago


Austin, United States TMF Health Quality Institute Full time
**Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.**

*This position is located Remote United States*

Position Purpose:

Performs advanced (senior-level) quality assurance work. Ensures decision makers adjudicate disputes accurately by performing quality audits, reviews, and publishing audit results and conducting meetings, providing coaching, and training on quality. Works under limited supervision, with considerable latitude for the use of initiative and independent judgement.

Essential Responsibilities:
  • Oversees, plans, and monitors the quality assurance program.
  • Oversees, plans, and audits to ensure timeliness, accuracy, and consistency in reconsideration/dispute resolution decisions.
  • Oversees, develops, and identifies individual and collective training opportunities based on audit findings and/or data analysis of reconsiderations/dispute resolution decisions to help improve individual and corporate quality.
  • Oversees, plans, prepares, reviews and analyses data to identify problems, trends and improvement opportunities.
  • Oversees, plans, and reviews reopened cases and cases from the problem log in order to identify trends and needs for improvement.
Minimum Qualifications

Education
  • Associate's degree or 60 or more credit hours towards a Bachelor's degree from an accredited college or university in healthcare or related discipline
    • Additional Medicare appeals or clinical experience in a healthcare setting may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)
Experience
  • Five (5) years medical dispute, Medicare appeals or clinical experience in a healthcare setting
  • Two (2) years of training
  • Quality experience
  • Healthcare Professional with demonstrated experience writing or making medical necessity decisions
  • Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience
Benefits

C2C offers an excellent benefits package, including:
  • Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
  • Section 125 plan
  • 401K
  • Competitive salary
  • License/credentials reimbursement
  • Tuition Reimbursement

EOE Minorities/Females/Vet/Disability

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

  • Austin, Texas, United States LSG Sky Chefs Full time

    Are you passionate about ensuring the highest standards of food safety in a fast-paced environment? LSG Sky Chefs is seeking a Quality Assurance Coordinator to join our team!Job OverviewWe are a leading provider of in-flight catering services, and we take pride in delivering exceptional quality and service to our customers. As a Quality Assurance...


  • Austin, United States LSG Sky Chefs Full time

    Job Title: Food Safety Quality Assurance Coordinator  Job Location: Austin-USA-78719  Work Location Type: On-Site    About us LSG Sky Chefs is one of the world’s largest airline catering and hospitality providers, known for its outstanding reputation and dynamic approach in the industry. Voted “Airline Caterer of the Year in North America”...


  • Austin, Texas, United States St. David's North Austin Medical Center Full time

    OverviewSt. David's North Austin Medical Center, a multi-specialty hospital in Texas with over 360 beds, offers an exciting opportunity for a skilled Emergency Room Clinical Nurse Coordinator to join their team.This role is perfect for individuals who are passionate about delivering high-quality patient-centered care and coordination of all functions in the...


  • Austin, Texas, United States Dept of State Health Services Full time

    Overview:The Department of State Health Services is seeking a highly skilled Quality Improvement Manager to join our team. This role will be responsible for coordinating quality improvement projects, providing high-level advice and counsel, and developing recommendations for programmatic issues.About the Job:This position is funded via a federal grant, with...


  • Austin, Texas, United States St. David's South Austin Medical Center Full time

    Company OverviewSt. David's South Austin Medical Center is a 368-bed acute care facility offering a range of complex specialties and sub-specialties. Our services include a nationally accredited oncology program with the area's only adult Transplant and Cellular Therapy Program; advanced trauma care with a Level II trauma center; full-service maternity and...


  • Austin, Texas, United States Quality Roofing Austin Full time

    Job OverviewQuality Roofing Austin is seeking a highly organized and skilled Construction Supervisor to lead our construction team in the Austin area. As a key member of our team, you will be responsible for ensuring projects are completed on time, within budget, and to the highest quality standards.Key Responsibilities:Manage daily construction activities,...

  • Project Coordinator

    5 months ago


    Austin, United States Texas Department of Aging & Disability Services Full time

    Job Description: Under the supervision of the Public Health Informatics Director, performs highly advanced consultative, coordinative, and technical assistance work. Coordinates projects appropriate for the Branch for new or existing programs and activities. Develops and monitors work plans, timelines, and deliverables for achieving project objectives,...


  • Austin, United States Texas Department of Aging & Disability Services Full time

    Job Description: Nurse III **PLEASE NOTE: The posted salary range is the full range for this position. Agency salary policy, budget and candidate’s qualifications will dictate final salary offer. Typically, salary offers are at or near the midpoint of the range, depending on the qualifications or other factors.** Designation Coordinators are...


  • Austin, Texas, United States Ambrose Upholstery Full time

    Job OverviewAmbrose Upholstery is seeking a skilled and detail-oriented Operations & Delivery Lead to join our team in Austin, TX. This dynamic role involves coordinating our delivery service, managing inventory, inspecting completed projects, assigning/reviewing work orders, and supporting sales.We offer:Competitive Salary: $45,000 - $60,000 per...


  • Austin, United States Disability Solutions Full time

    Job Description If you are in search of a new opportunity where you are able to use your accumulated knowledge to lead and develop a quality inspection team, this position is for you! The role is responsible for effective quality leadership, development, and performance (quality control, continuous process improvement, team development) for quality...


  • Austin, United States HVJ Associates Full time

    Job TitleQuality Manager/Lab ManagerLocationAustin, TX US (Primary)TX USCategoryProfessionalJob TypeFull-timeJob DescriptionQauality Manager/Lab ManagerMission/ Position Description Summary:The duties described below for a Laboratory Manager serves as guidance of all lab operations and the management of all lab team members. As the Lab Manager this position...


  • Austin, Texas, United States Health & Human Services Comm Full time

    **Job Title**: Program Monitoring Coordinator.As a Program Monitoring Coordinator at Health & Human Services Comm, you will be responsible for monitoring and evaluating contract facilities and sex offender treatment programs. Your key responsibilities will include developing and implementing techniques for monitoring agency programs, conducting quality...


  • Austin, Texas, United States AccentCare Full time

    Job Title: Clinical Care Coordination ManagerAbout AccentCare:We are a leading provider of home healthcare services, committed to delivering high-quality patient care and improving lives. Our team of experienced professionals is dedicated to making a difference in the lives of our patients and their families.About the Role:We are seeking a skilled Clinical...


  • Austin, Texas, United States MRI Full time

    Job OverviewWe are seeking a highly motivated Office Management Coordinator to oversee the activities of a production team in Austin, TX.As an Office Management Coordinator, you will be responsible for providing high-quality office management and ensuring seamless operations. Your expertise in organizational prowess, attention to detail, service orientation,...


  • Austin, United States Quality Pork Processors Full time

    If you're a strategic problem solver with a talent for making data-informed decisions, you could be a great fit for this full-time Industrial Process Engineer role with Quality Pork Processors! We need a meticulous and analytical person to help refine the daily processes at our Austin, MN company. Not only do you earn a competitive salary (based on...


  • Austin, Texas, United States Starcom consulting limited Full time

    Job Title: Agile Project CoordinatorWe are seeking a highly skilled and experienced Agile Project Coordinator to join our team at Starcom Consulting Limited.Job Description:Role OverviewThe Agile Project Coordinator will be responsible for managing and coordinating multiple projects simultaneously, ensuring timely delivery, and maintaining high-quality...


  • Austin, United States Premier Research Labs (PRL) Full time

    Position Summary The Senior Quality Engineer is responsible for leading thorough investigations into laboratory out-of-specification (OOS) results and quality incidents across internal and third-party laboratories to ensure compliance with industry regulations and internal standards. This role involves collaboration with cross-functional teams to identify...


  • Austin, Texas, United States Tech Mahindra Full time

    We are seeking a highly skilled Senior IT Project Coordinator to lead project activities across business and technical functions.Key Responsibilities:Coordinate project activities, manage dependencies, track milestones, and resolve issuesWork closely with development, quality assurance, and business teams to drive projects forwardDevelop and implement...

  • Care Coordinator

    7 days ago


    Austin, Texas, United States Ascension Health Full time

    At Ascension Seton, we are committed to delivering high-quality patient care and providing a positive work environment for our associates. As a Registered Nurse in our Case Management department, you will play a vital role in coordinating the overall interdisciplinary plan of care for patients from admission to discharge. **Job Summary:**The Care...

  • Service Coordinator

    1 week ago


    Austin, United States Texas Children's Hospital Full time

    Job DescriptionWe are searching for a Service Coordinator (RN) for the Operating Room someone who works well in a fast-paced setting. In this position, you will support excellence in clinical practice and the care of patients in accordance with their developmental stages. The Service Coordinator will help in the daily operations of the service by assisting...