Top 24 Quality assurance nurse remote Jobs in North Carolina

HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $79,425 - $101,267 a year
- Full-time
- Remote
- Microsoft Word
- Nursing
- RN License
- Disability insurance
- Health insurance
Remote LPN Customer Care Screener
ACC PREMIERE —Raleigh, NC
- $24 - $26 an hour
- Remote
- RN License
- Computer literacy
- Organizational skills
- Paid training
- Work from home
Quick Apply
Registered Nurse
GT Independence —Greensboro, NC
- Nursing
- RN License
- Mid-level
- Paid time off
Quick Apply
8d
Registered Nurse
GT Independence —Raleigh, NC
- Nursing
- RN License
- Mid-level
- Paid time off
Quick Apply
8d
Clinical Quality Assurance Specialist - Bone Marrow Transplant Program
UNC Health —Chapel Hill, NC
- $35.87 - $51.57 an hour
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
Senior Engineer – Stability Analysis (Remote Eligible-US)
GE Vernova —Wilmington, NC
- $111,200 - $213,200 a year
- Full-time
- Remote
- 5 years
- Engineering
- Pass drug screening
- Paid parental leave
- Paid holidays
Nurse Practitioner, Evenings, Nights and Weekends Per Diem
Chapters Health System, Inc —Raleigh, NC
- $52.50 an hour
- Part-time
- Remote
- Background check
- Nursing
- Microsoft Excel
Quick Apply
4d
Project Manager
Pavion Corp. —Knightdale, NC
- $90,000 - $120,000 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- Mid-level
Quick Apply
Lead I&C (Instrumentation & Controls) Software Test & Tooling Engineer
GE Vernova —Wilmington, NC
- $98,400 - $164,000 a year
- Full-time
- Remote
- Computer Science
- Engineering
- Pass drug screening
- Paid parental leave
- Paid holidays
Clinical Manager, Advocacy and Navigation
Well Dot, Inc —Chapel Hill, NC
- $80,000 - $90,000 a year
- Full-time
- RN License
- Licensed Clinical Social Worker
- HIPAA
Quick Apply
13d
Clinician/Therapist – Hybrid Behavioral Health Services
Mind & Mane, LLC —Rocky Mount, NC
- $40 - $70 an hour
- Part-time
- Hybrid work
- Bilingual
- Licensed Clinical Social Worker
- Mid-level
- Professional development assistance
- Flexible schedule
Quick Apply
9d
Practical Nurse (Outpatient)
US Military Treatment Facilities under DHA —Fort Bragg, NC
- $55,557 - $72,224 a year
- Online Application
- Hybrid work
- 18 years or older
- Nursing
- Medication administration
Clinical Support Tech I (Days) - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.12 - $25.51 an hour
- Full-time
- Acute care
- Vital signs
- Surgery
- Paid time off
Clinical Support Tech I - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.12 - $25.51 an hour
- Full-time
- Acute care
- Vital signs
- Surgery
- Paid time off
Staff Pharmacist - Independent Pharmacy Primary Care Internal Medicine
In-Clinic Rx —Benson, NC
- Full-time
- Internal Medicine
- Primary Care
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
PROJECT EXECUTIVE – HEALTHCARE TECHNOLOGY (ID# 607)
Volarify —Raleigh, NC
- $150,000 - $180,000 a year
- Full-time
- Construction site
- Mentoring
- Senior level
Quick Apply
Clinical Support Tech II - GI Surgery & Surgical Oncology Acute Care Unit
UNC Health —Chapel Hill, NC
- $18.84 - $26.77 an hour
- Full-time
- Acute care
- Surgery
- Hospital
- Paid time off
Nurse Lead (RN)
Always Best Care Senior Services —Burlington, NC
- $83,000 - $84,000 a year
- Full-time
- Nursing
- RN License
- 3 years
- Travel reimbursement
- Paid training
Quick Apply
11d
Staff Pharmacist
IN CLINIC RX LLC —Benson, NC
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Customer service
- Paid holidays
- Disability insurance
Quick Apply
Physician (Hematology and Oncology Program Manager)
US Veterans Health Administration —Salisbury, NC
- $350,000 - $400,000 a year
- Online Application
- Background check
- Medicine
- Surgery
- Paid holidays
- Loan repayment program

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quality assurance nurse remote jobs near north carolina

HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)

Alliance Health -
Morrisville, NC

Apply Now

Job Details

Full-time
$79,425 - $101,267 a year

Benefits

Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
Flexible schedule
Retirement plan

Qualifications

Nursing
Health information process improvement
Research
Health information data integrity
Medical record abstraction
Medicaid regulations
Medicaid
Health information management
Associate Degree in Nursing
Nursing
Quality assurance experience within healthcare

Full Job Description

The HEDIS Clinical Quality Analyst provides clinical direction, guidance, training, and quality oversight for all things related to the clinical aspect of Healthcare Effectiveness Data and Information Set (HEDIS). This position would oversee abstraction, overreads and quality analysis of HEDIS for both Prospective and Retrospective Seasons to ensure the company complies with the standards set by the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS). Performs quality improvement activities to monitor/maintain quality of care and compliance with applicable standards/regulations. Performs/coordinates HEDIS data collection, medical record review, and quality improvement activities as indicated.

This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.

Responsibilities & Duties

Oversight of HEDIS Projects

Subject matter expert (SME) for the National Committee for Quality Assurance (NCQA) HEDIS Measures. (Hybrid, Administrative and ECDS)
Review the quality of HEDIS internal processes/plans for alignment with procedures and/or best practices for supporting the HEDIS Team.
Responsible for participating in the development, research, and implementation of HEDIS improvement activities
Plan implementation of Primary Source Verification (PSV) and Medical Record Review Validation (MRRV) Audits
Oversees quality of abstraction, quality assurance (QA) and second level QA for HEDIS Hybrid Project and Supplemental Data Audit
Interpret qualitative and quantitative information and appropriately document findings
Make recommendations for improvement related to records reviewed and report findings
Identify system and/or operational issues hindering the attainment of quality performance standards as defined by NCQA, applicable state and Federal laws and regulations
Motivate, influence, and provide direction to staff assigned to the Hybrid and SDVA projects to ensure successful completion of project goals, deliverables, and timelines
Analyze and interpret technical specifications, business requirements, and regulatory guidance to support accurate implementation of HEDIS measures and project activities
Serve as a subject matter expert on NCQA and HEDIS resources, providing guidance, training, and consultation to project teams
Identify and escalate situations which may pose quality, compliance, and/or safety risks that may adversely affect the HEDIS Hybrid Audit, HEDIS Prospective Audit or SDVA Audit

Coordinate/Oversees Data Analysis and Quality Intervention and Report on Findings

Generate monthly/weekly HEDIS Quality reports on measure performance and submit to Directors, Managers, and Supervisors
Coordinates and oversees all quality management programs/projects ensuring compliance with all applicable regulatory bodies
Develops and implements quality management and error reduction programs as needed
Provide written feedback to Directors, Managers and Supervisors concerning quality concerns pertaining to individual performance, compliance risks/trends, root cause analysis and any system or process improvements recommendations related to the NCQA HEDIS measures

Effectively Measure the Key Output Variables to Ensure All Performance Changes are Accurately Assessed

Prepare analysis of initial and repeat HEDIS measures to evaluate efficacy of interventions and to improve approach for successfully resolving the root cause as needed
Evaluate validity and accuracy of supplemental data sources to draw appropriate conclusions

Analyze Changes in Performance to Determine the Impacts of Interventions

Perform any required data analysis to evaluate gaps in care
Prepare comprehensive reports to ensure adequate documentation and methodology to support findings and recommendations

Evaluate Knowledge Gaps of Staff and Coordinate Training

Creates/Updates HEDIS measure training manuals, tip sheets, measure assessments, pocket guides for HEDIS per NCQA Technical Specifications, annually
Conduct HEDIS measure training/testing yearly
Monitor training of staff for effectiveness and impact of outcomes from enhanced training

Minimum Requirements

Education & Experience

Required:

Graduation from an accredited school of nursing with a Registered Nurse (RN) license or Licensed Practical Nurse (LPN) and five (5) years of healthcare experience in HEDIS clinical quality and process improvement.

Additional Required Experience:

Experience with the NCQA Technical Specifications and Value Set Directory.

Experience with Medical Record Abstraction/Quality Analysis and oversight of HEDIS related duties for HEDIS to include the supplemental data audit, Prospective audit and Hybrid audit. Knowledge of NCQA Health Plan HEDIS data collection and reporting requirements and processes.

Understanding of the operational requirements for data collection in support of HEDIS or similar Quality programs.

Experience with the Medicaid population related to HEDIS Measures.

Preferred:

Data analysis and IT infrastructure of standard and non-standard data related to supplemental data experience.

Certified Professional in Healthcare Quality – CPHQ preferred.

Knowledge, Skills, & Abilities

Knowledge of North Carolina State and Federal rules and requirements related to the service continuum in North Carolina
Knowledge of Tailored Plan, Integrated Care and Care Management processes and regulatory requirements
Knowledge of best and promising practices for behavioral & physical health and/or intellectual/developmental disabilities
Microsoft Excel, Word, PowerPoint, SPSS, and Survey Monkey (or other online survey tool)
Strong clinical skills
Problem solving skills
Interpersonal Skills
Strong Analytical skills
Problem solving and conflict resolution skills
Strong diplomacy skills and discretion
Highly effective communication skills
Ability to negotiate and resolve issues with minimal assistance

Salary Range

$79,425 - $101,267/Annual

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity

An excellent fringe benefit package accompanies the salary, which includes:

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility

Education

Required

Associates or better in Nursing
Technical/other training or better in Nursing

Licenses & Certifications

Required

Certified Prof Coder
Nurse Practitioner
Registered Nurse

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Apply Now

Refine Your Search

quality assurance nurse remote jobs in north carolina

HEDIS Clinical Quality Analyst (Full Time, Remote, North Carolina Based)

Remote LPN Customer Care Screener

Registered Nurse

Registered Nurse

Clinical Quality Assurance Specialist - Bone Marrow Transplant Program

Senior Engineer – Stability Analysis (Remote Eligible-US)

Nurse Practitioner, Evenings, Nights and Weekends Per Diem

Project Manager

Lead I&C (Instrumentation & Controls) Software Test & Tooling Engineer

Clinical Manager, Advocacy and Navigation

Clinician/Therapist – Hybrid Behavioral Health Services

Practical Nurse (Outpatient)

Clinical Support Tech I (Days) - GI Surgery & Surgical Oncology Acute Care Unit

Clinical Support Tech I - GI Surgery & Surgical Oncology Acute Care Unit

Staff Pharmacist - Independent Pharmacy Primary Care Internal Medicine

PROJECT EXECUTIVE – HEALTHCARE TECHNOLOGY (ID# 607)

Clinical Support Tech II - GI Surgery & Surgical Oncology Acute Care Unit

Nurse Lead (RN)

Staff Pharmacist

Physician (Hematology and Oncology Program Manager)

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