Quality Assurance and Utilization Management Nurse

5 days ago


Sacramento, California, United States Hill Physicians Medical Group Full time

Job Overview: Hill Physicians Medical Group is seeking a Quality Assurance and Utilization Management Nurse to manage Quality Management (QM) and Health Resource Management (HRM) department functions. The successful candidate will oversee delegated activities, including NCQA, state, and federal regulatory requirements, and health plan delegation oversight programs for all regions.

Duties and Responsibilities:

  • Directs or oversees preparation for all health plan audits and represents Hill Physicians Medical Group at the audits for UM and QM.


  • Sacramento, California, United States Hill Physicians Medical Group Full time

    About the RoleWe are seeking an experienced Quality Assurance Nurse to join our team at Hill Physicians Medical Group. As a key member of our Quality Management and Health Resource Management departments, you will play a critical role in ensuring compliance with regulatory requirements and maintaining the highest standards of patient care.Your primary...


  • Sacramento, California, United States Hill Physicians Medical Group Full time

    We are seeking an accomplished healthcare professional to fill the role of Quality Management Nurse at Hill Physicians Medical Group. In this position, you will be responsible for managing quality management and health resource management functions, ensuring compliance with delegated activities, including NCQA, state, and federal regulatory requirements.The...


  • Sacramento, California, United States JobRialto Full time

    Job Description:We are seeking a highly motivated and experienced Quality Assurance Process Manager to join our team at JobRialto. As a key member of our software development process, you will play a crucial role in ensuring the quality of our software products.In this position, you will oversee quality assurance processes, including manual and automated...


  • Sacramento, California, United States WellSpace Health Full time

    About the JobWe are seeking a talented Quality Assurance Manager Clinical Operations to join our team at WellSpace Health. This role will involve managing quality improvement initiatives and ensuring compliance with regulatory requirements.The ideal candidate will have a strong background in quality assurance, with a minimum of two years of experience in a...


  • Sacramento, California, United States Forgen Full time

    Job Overview:Forgen is seeking a highly skilled Quality Assurance Manager to join our team. As a key member of our organization, you will be responsible for ensuring the highest quality standards are met in all aspects of environmental construction.About Us:We are a leading provider of geotechnical and environmental construction services, committed to...


  • Sacramento, California, United States VPE Thermal LLC Full time

    About the Role:VPE Thermal LLC is a world leader in microchannel heat exchanger design and manufacturing. We are seeking an experienced Quality Assurance Specialist to join our team.Job Summary:The successful candidate will be responsible for ensuring the quality and reliability of our products by performing inspections, tests, and evaluations. This role...


  • Sacramento, California, United States State of California Full time

    Company OverviewThe State of California is a leader in healthcare quality assurance, ensuring that patients receive the highest level of care. Our team is dedicated to maintaining the integrity of our healthcare system, and we are seeking a skilled professional to join us.Salary$7,214 - $9,473 per month, based on experience.Job DescriptionWe are seeking a...


  • Sacramento, California, United States IPEM SOLUTIONS INC Full time

    Join our team as a Software Quality Assurance SpecialistWe are looking for a highly skilled individual to work on a complex project replacing the existing mainframe and .NET systems with portals developed in modern technologies and platforms like Salesforce and Amazon AWS services.Key Responsibilities:Conduct quality assurance on Disability Insurance...


  • Sacramento, California, United States VPE Thermal LLC Full time

    About the RoleVPE Thermal LLC is seeking a skilled Quality Assurance Specialist to join our team.The ideal candidate will possess excellent analytical and problem-solving skills, with the ability to work independently and collaboratively as part of a global organization.Key Responsibilities:Interpret engineering drawings and specifications to determine...


  • Sacramento, California, United States Gemini Bio-Products Full time

    Job Title: Quality Assurance SpecialistJob Summary: Gemini Bio-Products is seeking a Quality Assurance Specialist to join our team. The successful candidate will be responsible for reviewing manufacturing and development Device History Records prior to release and ensuring compliance with all associated procedures.Review departmental completed records to...


  • Sacramento, California, United States State of California Full time

    About the RoleWe are seeking a highly skilled and motivated Accountability Support Unit Lead to join our team at the Department of Health Care Services. As a key member of our Quality and Population Health Management program, you will play a critical role in leading our efforts in clinical quality, health equity, and population health work.The selected...


  • Sacramento, California, United States IPEM SOLUTIONS INC Full time

    Join Our Team as a Quality Assurance ExpertWe are looking for a skilled Quality Assurance Expert to join our team and work on a 1+ year project enhancing the state's Disability Insurance System. The successful candidate will replace existing systems with modern technologies and platforms like Salesforce, Amazon AWS services, and AI/ML.Your Key...


  • West Sacramento, California, United States Gemini Bio-Products Full time

    OverviewGemini Bio-Products is a leading provider of cell culture products, instruments, and solutions to the global biotechnology industry. With a focus on quality and customer satisfaction, we are seeking a highly motivated and detail-oriented Quality Assurance Associate I to join our team.The successful candidate will be responsible for ensuring...


  • Sacramento, California, United States IPEM SOLUTIONS INC Full time

    Job OverviewWe are seeking a highly skilled Software Quality Assurance Analyst to join our team. As a remote employee, you will work closely with our client to ensure the highest standards of quality assurance are met throughout the software development lifecycle.About IPEM Solution Inc.We are an equal opportunity employer committed to providing a...


  • Sacramento, California, United States GATE Insight, Inc. Full time

    Job Title: Quality Assurance SpecialistJob Summary:We are seeking a Quality Assurance Specialist to join our team at GATE Insight, Inc. as a Test Lead. The successful candidate will have a minimum of three years of experience in software testing, test planning, and automation. The ideal candidate will have experience working with Agile/Scrum methodologies...


  • West Sacramento, California, United States Nippon Shokken U.S.A. Inc. Full time

    Nippon Shokken U.S.A. Inc. is committed to delivering high-quality food products that meet the highest standards of safety and quality. As a Quality Assurance Professional, you will play a critical role in ensuring the success of our mission.Job Summary:This position requires a highly motivated and detail-oriented individual who can conduct quality...


  • Sacramento, California, United States Nivagen Pharmaceuticals Full time

    About the RoleWe are seeking a skilled Pharmaceutical Quality Assurance Specialist to join our team at Nivagen Pharmaceuticals. This role is responsible for supporting the development, implementation, and maintenance of our Quality Management System (QMS) in compliance with regulatory requirements and industry standards.The ideal candidate will have a strong...


  • Sacramento, California, United States FS3 INC Full time

    Job DescriptionThis role requires a construction quality assurance specialist with expertise in the commercial building industry.The ideal candidate will have a strong background in inspection, design/build, and quality assurance/quality control.Detailed knowledge of DSA, HCAI, and ICC regulationsExperience in documenting and maintaining recordsSkilled in...


  • Sacramento, California, United States Saxon Global Full time

    We are looking for a Senior Quality Assurance Specialist to join our team at Saxon Global. As a Senior Quality Assurance Specialist, you will be responsible for ensuring the quality and accuracy of our software applications. This is a challenging role that requires strong analytical and problem-solving skills.ResponsibilitiesPlan and execute business...


  • Sacramento, California, United States Keurig Dr Pepper Full time

    Role SummaryWe are seeking a seasoned Quality and Environmental Assurance Director to lead our Sacramento, CA plant in achieving zero health and safety incidents, perfectly safe food as defined by FSMA, six sigma Quality performance, and 100% compliance to all FDA, EPA, and OSHA regulations.About the RoleThe successful candidate will be responsible for...