Clinical Quality Specialist
23 hours ago
As a Clinical Quality Specialist at US Tech Solutions, you will play a vital role in ensuring the delivery of high-quality healthcare services. Your primary responsibility will be to participate in the development and implementation of Quality Management (QM) Work Plan activities, focusing on improving quality products and services through measurement and analysis.
In this dynamic position, you will review documentation, evaluate Potential Quality of Care issues based on clinical policies and benefit determinations. You will also consider all documented system information as well as additional records/data presented to develop a determination or recommendation.
The ideal candidate should have excellent analytical skills, with the ability to navigate multiple system applications, gather data, and interpret results. Additionally, strong communication and problem-solving skills are essential for collaborating with internal/external clinicians to resolve complex cases. As a part of our team, you will contribute to the development and implementation of QM projects and activities, ensuring compliance with business, regulatory, and accreditation requirements.
A successful Clinical Quality Specialist should possess 3+ years of experience as an RN, with prior authorization utilization experience. You should also have Medcompass or AssureCare experience and knowledge of managed care, Medicare, and Medicaid. Strong UM experience, particularly inpatient utilization management review, is highly desirable. We offer a competitive salary ranging from $85,000 to $110,000 per year, depending on your qualifications and location.
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Clinical Research Quality Assurance Specialist
3 weeks ago
Chicago, Illinois, United States ZipHire Full timeOur client, a leading clinical research site network in the US, is seeking an experienced Quality Control Data Management Specialist to join their team. This is an exciting opportunity for professionals with backgrounds in healthcare quality, regulatory, or patient data to transition into data and quality roles.Key responsibilities will include reviewing...
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Clinical Respiratory Specialist
2 days ago
Chicago, Illinois, United States North Shore Defunct Full timeJob Title: Clinical Respiratory SpecialistLocation: Chicago, ILEstimated Salary:$65,000 - $85,000 per yearAbout the Job:We are seeking a skilled Clinical Respiratory Specialist to join our team at Swedish Covenant Hospital. As a Clinical Respiratory Specialist, you will be responsible for delivering high-quality respiratory care to patients, conducting...
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Clinical Cardiology Specialist
1 day ago
Chicago, Illinois, United States NavitsPartners Full timeNurse Clinician - Cardiac Cath LabJob Title: Clinical Cardiology SpecialistThis is a dynamic role in our team at NavitsPartners where you will lead nursing care and clinical decision-making in a fast-paced environment. The successful candidate will provide direct patient care during cardiac procedures, lead emergency response efforts as needed, and maintain...
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Clinical RN Specialist
2 days ago
Chicago, Illinois, United States Rush Full timeWe are seeking a highly skilled and compassionate Clinical RN Specialist to join our team at Rush University Medical Center in Chicago, IL. As a Clinical RN Specialist, you will play a vital role in providing exceptional patient care, leading clinical initiatives, and contributing to the growth and development of our organization.About the PositionThe...
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Medical Laboratory Specialist
3 weeks ago
Chicago, Illinois, United States Clinical Magnet Full timeA challenging opportunity has arisen for a skilled Medical Laboratory Specialist to join the team at Clinical Magnet. As a key member of our team, you will be responsible for performing and evaluating diagnostic procedures, working closely with other scientists to provide accurate results.Key Responsibilities:Apply principles and techniques of medical...
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Clinical Operations Specialist
6 days ago
Chicago, Illinois, United States Mindlance Full timeJob Title: Clinical Operations SpecialistAt Mindlance, we're seeking a skilled Clinical Operations Specialist to join our team. As a key member of our Utilization Management (UM) team, you will be responsible for ensuring compliance with UM and Quality Review (QR) standards across our network of healthcare providers.About the Role:This is a dynamic position...
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Clinical Dermatology Specialist
1 month ago
Chicago, Illinois, United States Rush University System for Health Full timeRush University System for Health, a leading academic medical center, invites applications for a Clinical Dermatology Specialist. We are seeking a qualified candidate to join our team and contribute to the clinical excellence and education of our department.The ideal candidate will have completed an ACGME accredited Dermatology Residency and be board...
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Clinical Nutrition Specialist
2 days ago
Chicago, Illinois, United States Sylvan Health Full timeAbout Sylvan Health">Sylvan Health is a mission-driven organization committed to improving patient lives through personalized nutrition. Our goal is to empower patients to live healthier lives by making nutrition more accessible and affordable.We are seeking a dedicated Clinical Nutrition Specialist to join our team. As a key member of our care team, you...
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Clinical Review Specialist
1 week ago
Chicago, Illinois, United States Elevance Health Full timeElevance Health seeks a skilled Clinical Review Specialist to join our team. As a valued member of our organization, you will play a critical role in ensuring the quality and efficiency of healthcare services. Your primary responsibilities will include conducting medical necessity reviews for diagnostic imaging procedures and out-of-network services,...
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Clinical Nursing Specialist
3 weeks ago
Chicago, Illinois, United States University of Chicago Medical Center Full timeJob Title: Clinical Nursing SpecialistWe are seeking a highly skilled and dedicated Clinical Nursing Specialist to join our team at the University of Chicago Medicine.
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Clinical Care Specialist
3 weeks ago
Chicago, Illinois, United States Ascension Health Full timeWe are seeking a dedicated and compassionate Clinical Care Specialist to join our team in Telemetry. In this role, you will work under the supervision of experienced healthcare professionals to provide high-quality patient care.About the RoleAs a Clinical Care Specialist, you will be responsible for performing clinical and non-clinical patient care...
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Clinical Utilization Review Specialist
3 weeks ago
Chicago, Illinois, United States Integrated Resources, Inc Full timeJob SummaryThis Clinical Utilization Review Specialist role is a vital part of our team at Integrated Resources, Inc.About the RoleWe are seeking a highly skilled and experienced Registered Nurse to join our team as a Clinical Utilization Review Specialist. In this role, you will play a crucial part in ensuring compliance with utilization management (UM) and...
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Quality Assurance Specialist
7 days ago
Chicago, Illinois, United States Carolina Therapeutic Services Community Developmen Full timeJob OverviewAt Carolina Therapeutic Services Community Development, we are seeking a skilled Quality Assurance Specialist to join our team. This is a dynamic role that requires a strong understanding of quality improvement principles and practices. The ideal candidate will have experience in monitoring quality systems, identifying areas for improvement, and...
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Clinical Educator Position
5 days ago
Chicago, Illinois, United States Elmhurst University - ABSN Clinical Full timeElmhurst University - ABSN Clinical Job DescriptionJob Type: Part-TimeLocation: Chicago, ILCompany OverviewElmhurst University values intellectual excellence, social responsibility, professional preparation, stewardship, community, and faith, meaning, and purpose. We are committed to providing a high-quality education to our students and are seeking a...
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Chicago, Illinois, United States Northwestern Memorial Healthcare Full timeNorthwestern Memorial Healthcare offers a rewarding career opportunity for a Clinical Utilization Management Specialist to join our team. This role is responsible for leading the Quality Utilization Specialist (QU) team in the Emergency Department, providing expert guidance on utilization management and level of care guidelines.About the RoleWe are seeking...
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Quality Assurance Quality Control Specialist
3 weeks ago
Chicago, Illinois, United States Alpha Baking Company Full timeWe are seeking a highly motivated and detail-oriented Quality Assurance Quality Control Specialist to join our team at Alpha Baking Company. As a Quality Assurance Quality Control Specialist, you will be responsible for ensuring that our products meet the highest standards of quality.The estimated annual salary for this role is $53,000 - $65,000 based on...
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Clinical Care Specialist
2 days ago
Chicago, Illinois, United States Northwestern Memorial Healthcare Full timeClinical Care Specialist OpportunityWe are seeking a highly motivated and experienced Clinical Care Specialist to join our team at Northwestern Memorial Healthcare. As a key member of our healthcare team, you will be responsible for providing exceptional patient care and service in a fast-paced clinical environment. **Key Responsibilities:**- Administer...
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Clinical Hemodialysis Nurse Specialist
4 weeks ago
Chicago, Illinois, United States Fresenius Medical Care North America Full timeAbout the RoleFresenius Medical Care North America is seeking a highly skilled Clinical Hemodialysis Nurse Specialist to join our team. As a member of our hemodialysis team, you will play a vital role in delivering high-quality patient care and contributing to the success of our organization.Job DescriptionThe Clinical Hemodialysis Nurse Specialist will be...
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Clinical Nurse Specialist
3 weeks ago
Chicago, Illinois, United States University of Illinois Chicago Full timeAbout the RoleAs a Clinical Nurse Specialist in Echocardiography, you will play a vital role in delivering high-quality patient care and advancing the field of echocardiography. This position requires a strong clinical background, excellent communication skills, and a commitment to continuous learning.ResponsibilitiesProvide direct patient care and education...
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Clinical Operations Specialist
7 days ago
Chicago, Illinois, United States Carolina Therapeutic Services Full timeJob DescriptionAt Carolina Therapeutic Services, we are seeking a skilled Clinical Operations Specialist to join our team. The ideal candidate will have a Master's degree in human services or a related field and at least one year of experience in MH/DD/SA.Responsibilities:Monitor risk management activities and review the implementation and efficiency of our...