Top 77 Clinical quality management analyst Jobs in Raleigh, Nc

Clinical Quality Management Analyst
Blue Cross and Blue Shield of North Carolina —Durham, NC
- $73,698 - $117,917 a year
- Full-time
- Hybrid work
- Nursing
- Mid-level
- Office
- Health insurance
- Dental insurance
Clinical Quality Analyst (Full-time Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $79,425 - $101,267 a year
- Full-time
- Remote
- LMFT
- Nursing
- RN License
- Disability insurance
- Health insurance
Epic EHR Helpdesk Analyst - Raleigh, NC - Contract Position
INFO ORIGIN INC —Raleigh, NC
- $35 - $45 an hour
- Weekends as needed
- Remote
- HIPAA
- Mid-level
Quick Apply
Grievance & Appeals Analyst (Full-time Remote NC Based)
Alliance Health —Morrisville, NC
- $61,439 - $79,871 a year
- Weekends as needed
- Remote
- Writing skills
- Mid-level
- Analysis skills
- Disability insurance
- Health insurance
Bachelor's-level Public Health Research Analyst - Evidence Synthesis
RTI International —Durham, NC
- $61,000 - $76,000 a year
- Full-time
- Remote
- Microsoft Excel
- Mid-level
- Bachelor's degree
- Paid parental leave
- Disability insurance
2d
Lead Procurement Analyst, Category Management (Clinical Research)
United Therapeutics —Research Triangle Park, NC
- Full-time
- Hybrid work
- 6 years
- Customer service
- ERP systems
- Paid parental leave
- Employee stock purchase plan
Systems Analyst II, Epic Clinical
WakeMed Health & Hospitals —Raleigh, NC
- Full-time
- Research
- Mid-level
- 3 years
Product Analyst
Clinisys —Morrisville, NC
- $90,000 - $120,000 a year
- Full-time
- Hybrid work
- Office
- 3 years
- Analysis skills
- Health insurance
- 401(k)
Operations Manager- Clinic Setting
Action Behavior Centers —Raleigh, NC
- $65,000 - $85,000 a year
- 6 years
- Master's degree
- Clinic
- Paid holidays
- Loan repayment program
Quick Apply
Management Consulting - Health Consultant
Accenture —Raleigh, NC
- $59,100 - $205,800 a year
- Full-time
- System design
- 3 years
- Master's degree
- Paid holidays
- Disability insurance
Health Information Technology Specialist East
IQVIA —Raleigh, NC
- $125,000 - $135,000 a year
- Full-time
- System design
- Mid-level
- Master's degree
Hybrid Board Certified Behavior Analyst (BCBA) Full Time/Part Time
Bee Wise Behavior —Zebulon, NC
- $70,000 - $110,000 a year
- Part-time
- Hybrid work
- Experience working with individuals with developmental disabilities
- Applied behavior analysis
- HIPAA
- Continuing education credits
- Mileage reimbursement
Quick Apply
Board Certified Behavior Analyst (BCBA)
Blossom ABA Therapy —Raleigh, NC
- $84,999.99 - $110,000.00 a year
- Part-time
- Mid-level
- Experience working with children
- Children
- Continuing education credits
- Paid holidays
Quick Apply
23h
Clinical Operations Supervisor/ BCBA
Sunny Skies ABA —Raleigh, NC
- $95,000 - $140,000 a year
- Part-time
- Hybrid work
- Background check
- Mid-level
- Supervising experience
- Continuing education credits
- Mileage reimbursement
Quick Apply
Senior Lead Board Certified Behavior Analyst (BCBA)
Learn & Leap Autism Center —Cary, NC
- $85,000 - $90,000 a year
- Full-time
- Background check
- 3 years
- Master's degree
- Relocation assistance
- Health insurance
Quick Apply
Quality & Organizational Excellence Leader
UNC Health —Morrisville, NC
- $33.37 - $47.97 an hour
- Full-time
- Hybrid work
- Master's degree
- Bachelor's degree
- Mentoring
19h
Facility Revenue Manager, Ambulatory Surgery Centers - Remote, M-F
Duke Health —Durham, NC
- Full-time
- Remote
- Surgery
- Writing skills
- System design
- Employee assistance program
Senior Business Systems Analyst
Blue Cross and Blue Shield of North Carolina —Durham, NC
- $89,174 - $142,679 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Analysis skills
- Health insurance
- Dental insurance
Junior Data/Business Analyst-
Software Technology Inc —Raleigh, NC
- SQL
- Organizational skills
- Entry level
Quick Apply
Chronic Disease Specialist
State of North Carolina - Health & Human Services —Durham County, NC
- $60,881 - $106,544 a year
- Full-time
- Hybrid work
- Mid-level
- 3 years
- Criminal background check
- Paid parental leave
- Health insurance
2d

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Clinical Quality Management Analyst

Blue Cross and Blue Shield of North Carolina -
Durham, NC

Apply Now

Job Details

Full-time
$73,698 - $117,917 a year

Benefits

Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Adoption assistance
Parental leave
Vision insurance
401(k) matching

Qualifications

Patient care

Full Job Description

Evaluates, analyzes and monitors staff or provider performance to achieve excellence in quality. Provides timely, relevant, accurate, and objective feedback to staff, providers, and the management team which includes a plan of action or recommendations when deficiencies are identified. Acts as technical resource and develops learning solutions that engage the learner and produces desired business goals and objectives.

What You'll Do

Performs quality audits of staff/providers to ensure compliance with departmental, Plans and regulates policies and procedures. Assists in designing effective learning solutions based on analysis of quality audit results and when quality deficiencies are identified. Monitors and reports on individual and department results to include benchmarking and trending.
Acts as a day-to-day resource for technical assistance and clinical decision making. Provides guidance with interpretation of clinical aspects of Corporate Medical Policy and other clinical guidelines to assist in making medical decisions. Aligns clinical decision-making processes with regulatory requirements (e.g. DOI/ERISA/NCQA). Keeps abreast of medical knowledge, care patterns, regulatory and governmental rules and regulations.
Works with management team to support decisions on workflow process, quality improvement, goal setting and data driven information-based decision-making. Provides timely feedback to management on staff/provider performance. Acts to facilitate change efforts and promote department, division and corporate goals.

What You Have

RN with 3 years of clinical experience or LPN with 5 years of clinical experience required.
For Behavioral Health specific roles, other applicable licensure may be considered with a minimum of 3 years of clinical experience.
Must have previous work experience in applicable business area (i.e. UM, CM, Medical Review or quality programs).
Bachelor's degree or advanced degree preferred.

Bonus Points

Experience presenting to clinical staff in primary care settings
Knowledge of HEDIS or healthcare quality measures
Strong Excel and PowerPoint proficiency
Ability to translate data into insights (data storytelling)
Strong presentation and communication skills
Relationship-building with provider systems
Flexibility and willingness to travel (25%)

What You’ll Get

The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
Work-life balance, flexibility, and the autonomy to do great work
Medical, dental, and vision coverage along with numerous health and wellness programs
Parental leave and support plus adoption and surrogacy assistance
Career development programs and tuition reimbursement for continued education
401k match including an annual company contribution
Learn more

Where You’ll Work

Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.

In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.

Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

Based on annual corporate goal achievement and individual performance.

$73,698.00 - $117,917.00

Skills

Clinical Decision Support (CDS), Clinical Quality Management, Clinical Research, Health Care, Healthcare Operations, Healthcare Policies, Health Information Technology (HIT), Medical Knowledge, Patient Safety, Quality Improvement

_____________________________________________________________________

JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected].

Apply Now

Refine Your Search

clinical quality management analyst jobs in raleigh, nc

Clinical Quality Management Analyst

Clinical Quality Analyst (Full-time Remote, North Carolina Based)

Epic EHR Helpdesk Analyst - Raleigh, NC - Contract Position

Grievance & Appeals Analyst (Full-time Remote NC Based)

Bachelor's-level Public Health Research Analyst - Evidence Synthesis

Lead Procurement Analyst, Category Management (Clinical Research)

Systems Analyst II, Epic Clinical

Product Analyst

Operations Manager- Clinic Setting

Management Consulting - Health Consultant

Health Information Technology Specialist East

Hybrid Board Certified Behavior Analyst (BCBA) Full Time/Part Time

Board Certified Behavior Analyst (BCBA)

Clinical Operations Supervisor/ BCBA

Senior Lead Board Certified Behavior Analyst (BCBA)

Quality & Organizational Excellence Leader

Facility Revenue Manager, Ambulatory Surgery Centers - Remote, M-F

Senior Business Systems Analyst

Junior Data/Business Analyst-

Chronic Disease Specialist

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