quality improvement specialist

PCC Community Wellness Center

<div>
 
 Job Summary:
 
 
 The Quality Improvement Specialist Nurse supports PCC&rsquo;s mission of delivering high-quality, patient-centered care by leading efforts to collect, analyze, and report clinical quality and program data, while also working closely to with leadership to support and implement clinical quality initiatives. This role is instrumental in aggregating quality and program data and supporting external reporting requirements.
 
 
 
 
 Essential Duties And Responsibilities
 
 
 
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 Participate in internal and external meetings and workgroups to enhance data strategy, tools, and infrastructure for performance measurement, while also contributing clinical insight to discussions from a quality improvement lens.
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 Synthesize, audit, and summarize pay-for-quality data received from health insurance carriers for use in organizational performance reviews.
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 Analyze EMR and billing data to detect inconsistencies or gaps; create performance dashboards and summary reports for leadership review.
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 Monitor progress toward clinical quality and population health goals through ongoing data analysis and performance tracking.
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 Contribute to special projects, grant reporting, and other data-related initiatives as assigned by leadership.
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 Collaborate with the Quality Improvement leadership and interdisciplinary teams to assist in meeting Patient-Centered Medical Home (PCMH) certification and recognition requirements.
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 Review and audit patient records and workflows to ensure compliance with program standards; identify opportunities for clinical process improvement.
 </li>
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 Support the building and maintenance of recurring and ad hoc data reports for internal departments, grant requirements, and organizational quality initiatives.
 </li>
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 Support preparation and submission of Uniform Data System (UDS) and other required quality reports by verifying data accuracy and assisting with data cleaning and reconciliation.
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 Evaluate existing data workflows and reporting processes to identify inefficiencies; recommend and implement data-driven improvements.
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 Other duties as assigned.
 
 
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 </ul>
 
 Experience/Training
 
 
 
 <ul>
 <li>
 Active Registered Nurse (RN) license in the state of IL in good standing).
 </li>
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 Bachelor of Science in Nursing (BSN) or equivalent education and experience.
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 2+ years&rsquo; experience in reporting and data management required.
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 Proficient in MS Office Business Applications to include: Outlook, Word, PowerPoint, and Excel.
 
 
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 </ul>
 
 Physical Demands
 
 
 
 <ul>
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 Must be able to remain in a stationary position a majority of the time.
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 Constantly operates a computer, computer printer, copy machine, and telephone.
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 Occasionally positions self to maintain exertion of physical strength to move objects of 10 pounds from one level to another.
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 Must be able to transport from one site to another.
 
 
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 </ul>
 
 Other Skills
 
 
 
 <ul>
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 Ability to read and write proficiently using the English language.
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 Communicates with healthcare staff. Must be able to exchange accurate information in these situations.
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 Follow-through, assume responsibility and use good judgment.
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 Maintain professionalism under stressful situations.
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 Self-motivated and directed with the ability to prioritize and work efficiently under pressure.
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 Ability to understand and follow verbal and written communication.
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 Detail oriented with the ability to work with minimal/no supervision.
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 Willingness to be part of a team-unit and cooperate in the accomplishment of departmental goals and objectives.
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 Effective and creative problem solving.
 
 
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 </ul>
 Do you consent to receiving text communications related to your job application via SMS from PCC COMMUNITY WELLNESS CENTER, which may include autodialed and automated messages, at the mobile number provided? Message frequency may vary and applicable data rates may apply.
 
 *
 
 
 
 Yes/No * Yes No
 
 
 Do you consent to receiving text communications related to your job application via SMS from PCC COMMUNITY WELLNESS CENTER, which may include autodialed and automated messages, at the mobile number provided? Message frequency may vary and applicable data rates may apply.
 
 *
 
 
 
 Yes/No * Yes No
 
 
 This value is required.
</div>

Quality Improvement Specialist Nurse

Confidential Company

<ul><li>Implement and monitor quality management systems</li><li>Conduct audits and prepare quality reports</li><li>Support accreditation (JCIA, DOH, TASNEEF, etc.)</li><li>Lead training and promote continuous improvement</li></ul>

Health Quality Officer

CVS Health

<div>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.
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.
Position Summary
The Quality Management Nurse (QM Nurse) supports Aetna Better Health of Texas by ensuring compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with quality improvement leadership, including clinical documentation review, Performance Improvement Projects (PIPs), ANE oversight, and policy development. The QM Nurse collaborates across teams to analyze data, implement interventions, and monitor outcomes for Medicaid programs (STAR, CHIP, STAR Kids). Additional responsibilities include provider education, committee coordination, and strategic reporting to align local efforts with state and national quality goals.
Key Responsibilities
Clinical Review &amp; Compliance<ul><li>
Review and evaluate clinical documentation for accuracy and compliance with regulatory and accreditation requirements.</li><li>
Apply clinical criteria and policies to member/provider claims and coordinate clinical resolutions with MD support.</li></ul>
Performance Improvement Projects (PIPs)<ul><li>
Design, implement, and evaluate PIPs in alignment with HHSC and EQRO guidance</li><li>
Conduct root cause analyses and develop culturally and linguistically appropriate interventions.</li><li>
Collaborate with informatics and clinical teams to refine data sets, monitor progress, and adjust interventions.</li><li>
Manage PIP data lifecycle, including tracking numerators/denominators, calculating rates, and preparing deliverables for HHSC/EQRO.</li><li>
Navigate HHSC submission portal, adapt workflows to meet evolving requirements, and advocate for process improvements.</li></ul>
ANE Oversight<ul><li>
Manage ANE and Critical Incident reporting process, ensuring compliance with DFPS and internal policies.</li><li>
Maintain ANE reporting grids, coordinate with case management, and lead training initiatives for mandatory reporters.</li><li>
Submit quarterly ANE reports to the State in collaboration with Informatics.</li></ul>
Policy Development &amp; Peer Support<ul><li>
Author and revise internal policies and contribute to peer review of others.</li><li>
Mentor peers on policy processes and participate in open office hours to improve team engagement.</li></ul>
Provider Communication<ul><li>
Develop and edit provider education on topics such as social determinants of health, formulary updates, and PIP progress.</li></ul>
Committee Support<ul><li>
Coordinate committee logistics, including agenda development, binder creation, and role verification.</li></ul>
Data Analysis &amp; Strategic Collaboration<ul><li>
Partner with analysts for ad hoc data requests and performance tracking</li><li>
Support dashboard development and participate in monthly strategy meetings to align local efforts with national quality goals.</li></ul> 
Required Qualifications<ul><li>
3+ years of clinical experience in a healthcare setting.</li><li>
2+ years as a Registered Nurse (RN) or License Practical Nurse/ License Vocational Nurse.</li><li>
Active, current, and unrestricted RN/LVP/LPN license in the state of residence.</li><li>
Proficiency in Microsoft Office Suite (Outlook, Excel) and ability to navigate web-based tools, data manipulation and reporting tools.</li></ul> 
Preferred Qualifications<ul><li>
Experience in Healthcare Quality, CPHQ preferred.</li><li>
Background in Managed Care.</li><li>
Familiarity with claims processing workflows.</li><li>
Experience with quality improvement, PIPs, ANE oversight, and policy development.</li></ul> 
Education<ul><li>
Associate&rsquo;s Degree in Nursing required.</li><li>
Bachelor of Science in Nursing (BSN) preferred.</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,095.00 - $155,538.00
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. 
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.
Great benefits for great people
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:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues 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.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 12/03/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Quality Management Nurse Consultant

Amazon

<div>
 
 
 DESCRIPTION
 
 
 
 
 Our overall mission is simple: We want Amazon to be the place where our customers can find, discover and buy anything online. Operations is at the heart of Amazon customer experience. Each action we undertake is done on behalf of our customers, as meeting their expectations makes us feel good. Whatever our customers want, we will find the means to deliver it. With your help, Amazon will continue to enable people to discover new worlds and implement innovation. This is your chance to make history.
 
 
 Role: Tier III - Escalation Specialist role in ICQA
 
 
 The ICQA team is seeking an excellent individual who is interested in becoming an Escalation Specialist. The Escalation Specialist reports into the local ICQA organization and is a key link between FC&rsquo;s and the Customer Service. He/She analyzes and solve operation issues that may have impact on Customer and acts on Customer issues to solve them and prevent further defects. Escalation Specialists holds responsibilities specific to the different Fulfillment Center areas to connect them for quick problems resolution. He/She will have the drive to develop him/herself and enhance existing skills and knowledge and meet targets and productivity expectations in line with company goals.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Act as the link between Customer Service and the ICQA and Operations team
 </li>
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 Contribute to solve operation issues to avoid impact on Customers and prevent future reoccurrence
 </li>
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 Support Customer Service requests related to stuck shipments, customer complaints, catalogue errors and process issues
 </li>
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 Perform Concession researches, analysis and escalations
 </li>
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 Conduct special research and deep dives, identify trends and generate reports that drive actions
 </li>
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 Support other Escalation Specialists as required
 </li>
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 Assist in ensuring successful area performance by analysis and reporting on business performance
 </li>
 <li>
 Research free replacements daily and provide detailed analysis of the errors
 </li>
 <li>
 Apply Amazon policies and guidelines related to ES role and general processes
 </li>
 <li>
 Support and work in the department as required
 </li>
 <li>
 Fully understands workflow and daily production goals
 
 
 </li>
 </ul>
 Our overall mission is simple: We want Amazon to be the place where our customers can find, discover and buy anything online. Operations is at the heart of Amazon customer experience. Each action we undertake is done on behalf of our customers, as meeting their expectations makes us feel good. Whatever our customers want, we will find the means to deliver it. With your help, Amazon will continue to enable people to discover new worlds and implement innovation. This is your chance to make history.
 
 
 Role: Tier III - Escalation Specialist role in ICQA
 
 
 The ICQA team is seeking an excellent individual who is interested in becoming an Escalation Specialist. The Escalation Specialist reports into the local ICQA organization and is a key link between FC&rsquo;s and the Customer Service. He/She analyzes and solve operation issues that may have impact on Customer and acts on Customer issues to solve them and prevent further defects. Escalation Specialists holds responsibilities specific to the different Fulfillment Center areas to connect them for quick problems resolution. He/She will have the drive to develop him/herself and enhance existing skills and knowledge and meet targets and productivity expectations in line with company goals.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Act as the link between Customer Service and the ICQA and Operations team
 </li>
 <li>
 Contribute to solve operation issues to avoid impact on Customers and prevent future reoccurrence
 </li>
 <li>
 Support Customer Service requests related to stuck shipments, customer complaints, catalogue errors and process issues
 </li>
 <li>
 Perform Concession researches, analysis and escalations
 </li>
 <li>
 Conduct special research and deep dives, identify trends and generate reports that drive actions
 </li>
 <li>
 Support other Escalation Specialists as required
 </li>
 <li>
 Assist in ensuring successful area performance by analysis and reporting on business performance
 </li>
 <li>
 Research free replacements daily and provide detailed analysis of the errors
 </li>
 <li>
 Apply Amazon policies and guidelines related to ES role and general processes
 </li>
 <li>
 Support and work in the department as required
 </li>
 <li>
 Fully understands workflow and daily production goals
 
 
 </li>
 </ul>
 
 
 BASIC QUALIFICATIONS
 
 
 
 
 <ul>
 <li>
 1+ years of Microsoft Office products and applications experience
 </li>
 <li>
 High school or equivalent
 </li>
 <li>
 Work a flexible schedule/shift/work area, including weekends, nights, and/or holidays
 </li>
 <li>
 Can lift up to 49 pounds, stand/walk during shifts lasting up to 12 hours, and be able to frequently push, pull, squat, bend, and reach
 </li>
 <li>
 Work 40 hours/week, and overtime as required
 
 
 </li>
 </ul>
 
 
 PREFERRED QUALIFICATIONS
 
 
 
 
 <ul>
 <li>
 Expert in Microsoft Excel, VBA, SQL, and other databases
 </li>
 <li>
 Ability of having developed tools, data collection processes, and data management systems
 </li>
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 Ability to handle multiple, competing tasks in a deadline-driven environment
 
 
 </li>
 </ul>
 Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit https://amazon.jobs/content/en/how-we-hire/accommodations for more information. If the country/region you&rsquo;re applying in isn&rsquo;t listed, please contact your Recruiting Partner.
 
 
 
 
 Company
 
 - Afaq - Warehouse Branch
 
 
 Job ID: A3108998
</div>

ICQA Escalation Specialist

DM Healthcare

<h3>Key Responsibilities:</h3><ul><li>Plan, schedule, and conduct clinical audits across multiple Aster Clinic branches in Dubai.</li><li>Evaluate compliance with clinical guidelines, patient safety protocols, infection control practices, and other quality indicators.</li><li>Identify gaps, non-conformities, and risks; recommend corrective and preventive actions (CAPA).</li><li>Work collaboratively with medical and nursing teams to implement quality improvement plans.</li><li>Monitor key performance indicators (KPIs) and contribute to quality data analysis and reporting.</li><li>Support internal and external quality assessments, including DHA inspections and JCI accreditations.</li><li>Facilitate staff training on quality standards, clinical documentation, and audit readiness.</li><li>Maintain proper documentation and reporting in alignment with Aster&#x27;s quality management system.</li><li>Escalate critical quality concerns to the Quality Manager or higher authorities, where necessary.</li></ul> <h3>Key Skills &amp; Competencies:</h3><ul><li>Clinical Audits (mandatory)</li><li>Knowledge of DHA and JCI standards</li><li>Root Cause Analysis &amp; Corrective Action Planning</li><li>Strong analytical and reporting skills</li><li>Excellent communication and interpersonal abilities</li><li>Attention to detail and strong documentation practices</li><li>Ability to work independently and across multi-disciplinary teams</li><li>Proficient in Microsoft Office Suite (Excel, Word, PowerPoint)</li></ul>

Senior Quality Executive-Heatlcare

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