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include the following. Other duties may be assigned. Creates statistical approaches and analyze data generated by multiple providers or from various review processes (e.g., identifying benchmarks or care, peer groups, and stratification). Trends data to understand opportunities for improvement or focused investigation. Develops statistically sound designs for quality improvement projects implement
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System and process analysis with evaluation and recommendations to increase performance. Collaborates with the customer to design and adapt processes and deliverables to meet changing needs. Utilizes measurement systems to evaluate performance and improvement. Identifies opportunities for improvement; assists teams in developing and implementing improvement strategies. Supervisory Responsibilities
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System and process analysis with evaluation and recommendations to increase performance. Collaborates with the customer to design and adapt processes and deliverables to meet changing needs. Utilizes measurement systems to evaluate performance and improvement. Identifies opportunities for improvement; assists teams in developing and implementing improvement strategies. Supervisory Responsibilities
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While medical review and support of review determinations will be the primary responsibilities of this position, the Medical Director job description includes the following essential duties and responsibilities. Other duties may be assigned. Provides clinical information to teams Medical Review Oversight may include Physician peer review activities Criteria development and assessment Correspondenc
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Medical Director Mississippi Hospice Medical Review Contract Job Location Jackson, MS Position Type Full Time/Regular Qlarant is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care o
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Medical Director ID Hospice Medical Review Contract Job Location Boise, ID Position Type Full Time/Regular Qlarant is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization
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Medical Director Hospice Medical Review Contract Job Location Los Angeles, CA Position Type Full Time/Regular Qlarant is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organizat
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Interventional Cardiologist Contract Home based Job Location Dallas, TX Position Type Consulting Qlarant is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality r
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include some or all of the following. Other duties may be assigned. Review Explanation of Benefit (EOB) cases, beneficiary, provider, and/or pharmacy cases for drug seeking, drug selling, beneficiary and other potential overpayment, fraud, waste, and abuse. Completes desk review or field audits to meet applicable contract requirements and to identify evidence of potential overpayment or fraud. Eff
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Medical Review Nurse Medicare/Medicaid Audit Job Location Cerritos, CA Position Type Full Time/Regular Qlarant, Inc., is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We're a national leader in fighting fraud, waste and abuse for large organizations across the country. Qla
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Medical Review Nurse Medicare/Medicaid Audit Job Location Chicago, IL Position Type Full Time/Regular Qlarant, Inc., is a not for profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We're a national leader in fighting fraud, waste and abuse for large organizations across the country. Qlar
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include some or all of the following. Other duties may be assigned. Review Explanation of Benefit (EOB) cases, beneficiary, provider, and/or pharmacy cases for drug seeking, drug selling, beneficiary and other potential overpayment, fraud, waste, and abuse. Completes desk review or field audits to meet applicable contract requirements and to identify evidence of potential overpayment or fraud. Eff
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Qlarant
- Baltimore, MD
Manages business development and proposal efforts for Qlarant, supporting new and existing business development opportunities. Proposal Management Manages and directs all technical and business proposal efforts (leads team, but also contributes) from start to finish, including, but not limited to Works with Technical Leads in Capture Management and other pre RFP activities Review/interpret RFP req
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Working with the corporate leadership team and business unit leaders is responsible for the acquisition of new business. This is a hands on position requiring the ability to identify and pursue sales opportunities for Qlarant products and services primarily in state and federal government as well as new market identification and penetration. Requires considerable interaction with both internal and
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include the following. Other duties similar in level and scope may be assigned based on the specifics of the project and/or client contract. Single contractor point of contact with/for the Veteran's Health Administration requests for SME support and any matter related to contractor performance Reviews project proposal or plan to have knowledge of project requirements, procedures for accomplishing
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