clinical oversight manager

HRCONSOL

<p><b>Key ResponsibilitiesClinical Oversight &amp; Quality Assurance</b></p><ul><li>Conduct regular audits of medical officers&rsquo; performance, SOAP notes, and case documentation.</li><li>Conduct at least two physical audits per doctor annually.</li><li>Monitor compliance with clinical protocols, guidelines, and ethical standards.</li><li>Review and analyze EMR data for accuracy, completeness, and effective utilization.</li><li>Identify performance gaps and recommend corrective actions for improvement.</li></ul><p><b>Training &amp; Capacity Building</b></p><ul><li>Develop, organize, and conduct Continuing Medical Education (CME) sessions and refresher trainings for medical staff.</li><li>Evaluate training needs based on audit findings and clinical performance trends.</li><li>Ensure all CME content aligns with current medical standards and organizational goals.</li><li>Develop and implement comprehensive orientation programs for doctors, ensuring smooth onboarding and familiarization with policies, protocols, EMR systems, and workflows.</li></ul><p><b>Operational Management</b></p><ul><li>Oversee and manage doctors&rsquo; schedules, rotations, and leave plans to ensure uninterrupted service delivery.</li><li>Coordinate with HR and Operations teams for staffing and coverage requirements.</li><li>Support the development of clinical presentations, reports, and dashboards for internal and external stakeholders.</li></ul><p><b>Policy &amp; Protocol Development</b></p><ul><li>Review and update clinical SOPs, protocols, and policies to ensure compliance and relevance.</li><li>Collaborate with the management team to implement evidence-based practices.</li><li>Ensure all documentation and operational activities comply with organizational and regulatory standards.</li></ul><p><b>Monitoring, Reporting &amp; Coordination</b></p><ul><li>Prepare regular performance and compliance reports for management review.</li><li>Coordinate with technical and operational teams to streamline documentation and reporting.</li><li>Provide administrative support in audits, program evaluations, and donor compliance reviews.</li></ul><p><b>Requirements</b></p><ul><li>MBBS / MCPS (or equivalent).</li><li>4&ndash;6 years of experience in healthcare administration, clinical management, or supervision.</li><li>Strong understanding of clinical workflows, EMR systems, and quality assurance mechanisms.</li><li>Excellent leadership, analytical, and communication skills.</li></ul><p>Job Type: Full-time</p><p>Work Location: In person</p>

Medical Administrator

CVS Health

<div><p>At CVS Health, we&rsquo;re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.</p><p></p><p>
As the nation&rsquo;s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues &ndash; caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.</p><p></p><p><b>
Position Summary</b></p><p>
This position will be working from home anywhere in the continental US.</p><p>
Standard business hours Monday-Friday.</p><ul><li>
Accountable for conducting oversight of entities that are contracted to perform clinical functions on Aetna's behalf.</li><li>
Monitor and track delegated entities compliance with regulatory and NCQA requirements.</li><li>
Communicate to delegated entities about industry standards, Aetna policies, and best practices.</li><li>
Accountable for preparing delegation oversight resources for NCQA and regulatory reviews</li><li>
This position supports NCQA, CMS, and other regulatory compliance initiatives.</li></ul><p><b><br>
Required Qualifications</b></p><ul><li>
3&ndash;5 years of experience in Quality Management within the healthcare industry</li><li>
Demonstrated ability to consistently meet deadlines in a fast-paced environment</li><li>
Strong communication and interpersonal skills, with a proven ability to collaborate effectively across teams</li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li>
2 to 3 years prior experience working in Commercial/Medicare or Medicaid lines of business</li><li>
Medical Terminology and Claims Experience</li><li>
QuickBase Experience</li><li>
Experience with flexing and shifting priorities</li><li>
Experience working independently and collaboratively to solve problems, make decisions, and complete work/projects</li><li>
Growth mindset (developing yourself and others) skills</li></ul><p><b><br>
Education</b></p><ul><li>
Bachelors Degree Preferred</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$43,888.00 - $102,081.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 11/21/2025<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Analyst, Health Care Quality Management - Work at Home

Canyon Home Care and Hospice

<div><div><div>Location: Colorado and Arizona (Travel Required)</div></div><div><div>
Job Type: Full-Time</div></div><div><div>
Position Summary:</div></div><div><div>
The Regional Clinical Manager is responsible for providing clinical oversight, mentorship, and operational support to the Clinical Directors and nursing teams across all home health and hospice branches in Colorado and Arizona. This role ensures clinical excellence, regulatory compliance, and quality improvement initiatives across the state. The Regional Clinical Manager works collaboratively with the Home Office Clinical Team, Clinical Directors and branch leadership to drive best practices in patient care, staff training, and performance improvement.</div></div><div><div>
Key Responsibilities:</div></div><div><div>
Clinical Leadership &amp; Oversight:</div></div><ul><li><div>
Provide statewide clinical oversight for home health and hospice services, ensuring consistent quality of care across all locations.</div></li><li><div>
Partner with Clinical Directors to implement and maintain clinical best practices, policies, and procedures.</div></li><li><div>
Conduct onsite and virtual visits to support teams in managing complex patient cases, addressing compliance issues, and improving clinical outcomes.</div></li><li><div>
Lead quality assurance and performance improvement (QAPI) initiatives, ensuring high patient satisfaction and regulatory compliance.</div></li><li><div>
Oversee clinical documentation audits, providing coaching and feedback to improve accuracy, efficiency, and compliance.</div></li></ul><div><div>
Support &amp; Development of Clinical Directors:</div></div><ul><li><div>
Serve as a mentor and advisor to Clinical Directors, helping them navigate leadership challenges and improve their effectiveness.</div></li><li><div>
Assist in training and onboarding new Clinical Directors and nursing leaders to ensure consistency in clinical operations.</div></li><li><div>
Facilitate monthly Clinical Director meetings to review metrics, discuss challenges, and align goals across branches.</div></li><li><div>
Provide hands-on support for TPE (Targeted Probe and Educate) audits, state and federal surveys, and compliance-related initiatives.</div></li></ul><div><div>
Staff Training &amp; Development:</div></div><ul><li><div>
Conduct statewide education and training programs for clinical staff, covering topics such as regulatory updates, documentation best practices, and symptom management.</div></li><li><div>
Lead skills labs, in-services, and case study reviews to enhance nursing competency.</div></li><li><div>
Support retention efforts by fostering a strong clinical culture, engagement, and professional development opportunities.</div></li></ul><div><div>
Regulatory Compliance &amp; Quality Improvement:</div></div><ul><li><div>
Ensure all clinical practices adhere to Medicare, Medicaid, and accreditation requirements for home health and hospice.</div></li><li><div>
Assist in preparing for surveys and audits, developing action plans to address deficiencies.</div></li><li><div>
Track key clinical performance indicators (KPIs) such as rehospitalization rates, infection rates, and documentation compliance, implementing improvement plans as needed.</div></li><li><div>
Work closely with interdisciplinary teams, including administrators, physicians, and quality leaders, to enhance patient care.</div></li></ul><div><div>
Operational &amp; Strategic Support:</div></div><ul><li><div>
Provide temporary leadership support to branches with vacancies in Clinical Director roles.</div></li><li><div>
Assist with problem-solving and troubleshooting operational challenges that impact clinical efficiency and quality.</div></li><li><div>
Collaborate with senior leadership to develop strategic initiatives that improve clinical outcomes and streamline operations.</div></li><li><div>
Travel across Colorado and Arizona to support branches, with a mix of onsite visits between locations. There will also be occasional travel to Utah for Home Office training and support.
</div></li></ul><div><div>Qualifications:</div></div><ul><li><div>
Active Registered Nurse (RN) license in Colorado and Arizona.</div></li><li><div>
Minimum 5 years of home health and hospice experience in a leadership or quality role (Clinical Director, Quality Manager, or similar).</div></li><li><div>
Strong knowledge of Medicare, Medicaid, and accreditation standards for home health and hospice.</div></li><li><div>
Demonstrated experience in mentoring, training, and developing clinical leaders.</div></li><li><div>
Proficiency in electronic medical records (EMR) systems (experience with MatrixCare a plus).</div></li><li><div>
Excellent leadership, communication, and problem-solving skills.</div></li><li><div>
Ability to travel extensively across the state (valid driver&rsquo;s license and reliable transportation required).</div></li></ul></div>

Regional Clinical Manager-Colorado and Arizona

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Medical Administrator

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Analyst, Health Care Quality Management - Work at Home

Regional Clinical Manager-Colorado and Arizona