Looking for a new role as a Qualis Health in Milwaukee, WI? This Contract position is perfect for professionals in the Hospitals and Health Care sector. Gain hands-on experience in the Research, Analyst, and Information Technology department, where you’ll be at the forefront of exciting projects and innovation.
Why This Job Is Great for You:
- Employee Rating: Rated 4.8/5 by employees — get a sense of the company culture!
- Job Level: This role is ideal for professionals at the Mid-Senior level Level Job.
- Posted: Posted 14 hours ago, this role is still accepting applications. Act fast and apply today!
This opportunity offers valuable experience in the Research, Analyst, and Information Technology department and will help you advance your career in the dynamic world of Hospitals and Health Care.
Find More Jobs Like This in Milwaukee and Across WI on ApplyMates.
“Qualis Health” Company Job Details
- Company Name: Qualis Health
- Work Type: Contract
- Rating: 4.8 / 5
- Location: Milwaukee, WI
- Industry: Hospitals and Health Care
- Department: Research, Analyst, and Information Technology
- Experience Level: Mid-Senior level
- Job Creation Duration: 14 hours ago
Job Details of Senior Clinical Reviewer For External
JOB REQUIREMENTS: Senior Clinical Reviewer for External Quality Review
(EQR) Services LinkedIn Twitter Email Message Share Category Care
Management Job Location Remote Tracking Code 134798 Industry Health Care
Job Level Mid Career Position Type Full-Time/Regular Years of Experience
5+ to 7 Years Comagine Health is seeking candidates for a Senior
Clinical Reviewer for External Quality Review (EQR) Services. In this
role, you are responsible for supporting state external quality review
contracts by leading and coordinating prior authorization and other
audit activities, coordinating with internal teams on project timelines
and deliverables, analyzing health plan data, and conducting audit
reviews. You will contribute to the development of reports and other
deliverables, and communicate audit findings and recommendations to
state Medicaid agencies. Some key responsibilities include: Provide
daily oversight and monitoring of the project/contract, deliverables and
staff supporting the activities. Act as a resource (i.e., subject matter
expert) for project/contract staff and other non-clinical staff
regarding audit processes, and clinical/utilization management/prior
authorization matters. Ensure staff supporting project/contract
activities have the tools and resources needed to complete their work in
a high-quality manner. Assist with initial orientation and training of
new staff assigned to EQR projects/contracts. Maintain and monitor
individual and team-level performance expectations for deliverables. Who
is Comagine Health? Comagine Health is a national, nonprofit, health
care consulting firm. We work collaboratively with patients, providers,
payers, and other stakeholders to reimagine, redesign and implement
sustainable improvements in the health care system. As a trusted,
neutral party, we work in our communities to address key, complex
health, and health care delivery problems. In all our engagements and
initiatives, we draw upon our expertise in quality improvement, care
management, health information technology, analytics, and research. We
invite our partners and communities to work with us to improve health
And Redesign The Health Care Delivery System. Required Qualifications
Bachelor’s Degree in Nursing (an equivalent combination of education
and/or work experience in a related field may be substituted). Current,
active, unrestricted RN Licensure required. 3 years of clinical (direct
patient care) experience. 3 years of utilization review (or other
medical management) experience including conducting prior authorization
reviews. Desired Qualifications: 1 year experience… For full info
follow application link. Equal Employment Opportunity Employment
Comagine Health is an Equal Employment Opportunity/Affirmative Action
Employer that embraces and practices diversity, reflecting the
communities we serve. We encourage minorities, protected veterans and
individuals with disabilities to apply. ***** APPLICATION
INSTRUCTIONS: Apply Online: ipc.us/t/442802D9315B4CCC