Claims Quality Audit Director jobs in Santa Maria, CA

Claims Quality Audit Director directs and oversees the operations of the claims quality audit department to follow the audit policies, procedures and regulation. Provides professional knowledge and guidance on technical or procedural problems. Being a Claims Quality Audit Director creates claims audit policies and procedures. May recommend changes in claims processing procedures. Additionally, Claims Quality Audit Director typically Requires a bachelor's degree. Typically reports to top management. The Claims Quality Audit Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. To be a Claims Quality Audit Director typically requires 5+ years of managerial experience. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. (Copyright 2024 Salary.com)

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DIRECTOR CLINICAL QUALITY IMPROVEMENT
  • Impact Solutions Inc
  • Templeton, CA FULL_TIME
  • DIRECTOR CLINICAL QUALITY IMPROVEMENT
    Templeton, CA
    160-210K Bonus Signing Bonus Paid Relocation

    The individual in this position is a key member of the hospital management team, and provides leadership and oversight to the strategic development and implementation of the quality and patient safety programs (performance improvement, patient safety, and accreditation) with responsibility for planning, organizing, directing the managerial and operational activities of the infrastructure required to support these services. The DCQI provides leadership in the promotion of a Culture of Safety, effective use of performance improvement methodologies, and data integrity, validity, and reliability. This position serves as the liaison with The Joint Commission, CMS, and other pertinent regulatory agencies and oversees the organization's continuous survey readiness processes. The DCQI works collaboratively with the Medical Staff to promote evidence-based quality and safety, patient-focused care aimed at optimal patient outcomes. The DCQI is responsible for ensuring the quality improvement goals are aligned and support organizational goals and priorities.

    Minimum Education/Minimum Experience:
    Degree (Bachelors, Masters or Doctorate) in a health related field, with 5 years of relevant hospital management experience or other allied health professionals who have extensive hospital experience (>7 years, or other pertinent credentials) in the areas of responsibility will be considered.

    Related Skills:Experience in quality/performance improvement, and as applicable in case management and other related areas of responsibility. Demonstrated knowledge of Performance Improvement, Outcomes and Quality Management. As applicable, DCQI candidate also has demonstrated knowledge in the areas of Peer Review, Risk Management, Patient Safety, Infection Control Prevention and Reporting. Ability to interpret and process data in an analytical manner. Excellent communication (written and verbal) and presentation skills. Computer operational skills, understanding of statistics, spreadsheets and database systems. Current understanding of regulations as it relates to Joint Commission, State specific requirements, and Centers for Medicare & Medicaid Services (CMS). Demonstrated understanding of Quality Improvement Organization (QIO) guidelines/required processes and understanding of current trends in quality and other areas of responsibility as applicable. Ability to lead and coordinate activities of a diverse group of people. Ability to work with hospital team to motivate relevant constituencies to embrace change as required by the hospital's Commitment to Quality and other clinical initiatives.

    Licenses/Certificates/Credentials:
    Registered Nurse Preferred, Certified Professional Risk Management Certification and/or Certified Professional Healthcare Quality Certification within three years of hire.

    Job Type: Full-time

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Employee assistance program
    • Flexible spending account
    • Health insurance
    • Life insurance
    • Paid time off
    • Tuition reimbursement
    • Vision insurance
  • 10 Days Ago

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Night Audit
  • Edgewater Inn and Suites
  • Pismo Beach, CA FULL_TIME
  • Do you love Pismo Beach? Do you love people? Are you ready to get out of the house and get back to work? If so, we've got the perfect position(s) for you here at the Edgewater Inn & Suites! So if you ...
  • 27 Days Ago

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Night Audit
  • Pacifica Hotel Company
  • Cambria, CA FULL_TIME
  • Pacifica Hotels is searching for a Night Audit to join the team at Fireside Inn. The Night Audit will be responsible for assisting guests in all guest services related functions. The Night Audit will ...
  • 1 Month Ago

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Night Audit
  • Pacifica Hotels
  • Cambria, CA FULL_TIME
  • Pacifica Hotels is searching for a Night Audit to join the team at Fireside Inn. The Night Audit will be responsible for assisting guests in all guest services related functions. The Night Audit will ...
  • 1 Month Ago

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Night Audit
  • Sandcastle Hotel on the Beach
  • Pismo Beach, CA FULL_TIME
  • Pacifica Hotels is searching for a part-time Night Auditor (Night Front Desk) to join the team at Sandcastle Hotel on the Beach, Pismo Beach, CA. The Night Auditor will be responsible for assisting gu...
  • 1 Month Ago

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Night Audit
  • Pacifica Hotels
  • Pismo Beach, CA PART_TIME
  • Pacifica Hotels is searching for a part-time Night Auditor (Night Front Desk) to join the team at Sandcastle Hotel on the Beach, Pismo Beach, CA. The Night Auditor will be responsible for assisting gu...
  • 1 Month Ago

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0 Claims Quality Audit Director jobs found in Santa Maria, CA area

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Psychologist I/II #1871
  • Tri-Counties Regional Center
  • Santa Maria, CA
  • Job Description Job Description **We have a current opening for a Psychologist on our Santa Maria Team** Job Title: Psyc...
  • 4/24/2024 12:00:00 AM

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Manufacturing Engineer
  • Entegris
  • San Luis Obispo, CA
  • Why work at Entegris? At Entegris, we use advanced science to enable technologies that transform the world, and we are s...
  • 4/23/2024 12:00:00 AM

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Medical Assistant
  • CommonSpirit Health
  • Santa Maria, CA
  • Overview Dignity Health's Pacific Central Coast Health Centers (PHC) is a non-profit Community clinic organization compr...
  • 4/22/2024 12:00:00 AM

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Supply Chain Director
  • Akkodis
  • Santa Maria, CA
  • Akkodis is seeking a Director of Supply Chain for a Direct Hire position with a client located Santa Maria, CA In this r...
  • 4/22/2024 12:00:00 AM

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Internal Revenue Agent (Examination Analyst - Examiner) 12 MONTH ROSTER - AMENDED
  • Department Of The Treasury
  • Santa Maria, CA
  • Duties WHAT IS THE SMALL BUSINESS/SELF EMPLOYED (SBSE) DIVISION? A description of the business units can be found at: ht...
  • 4/22/2024 12:00:00 AM

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Supervisory Internal Revenue Agent 12 month Roster
  • Department Of The Treasury
  • Santa Maria, CA
  • Duties WHAT IS THE LBI - Large Business and InternationalDIVISION? A description of the business units can be found at: ...
  • 4/22/2024 12:00:00 AM

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Manufacturing Engineer
  • Entegris
  • San Luis Obispo, CA
  • Why work at Entegris? At Entegris, we use advanced science to enable technologies that transform the world, and we are s...
  • 4/21/2024 12:00:00 AM

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Purchasing Manager
  • LAUNCH Technical Workforce Solutions, LLC
  • Santa Maria, CA
  • Overview: Purchasing Manager LAUNCH Technical Workforce Solutions is seeking an Purchasing Manager for a direct hire opp...
  • 4/20/2024 12:00:00 AM

Santa Maria is a city near the Southern California coast in Santa Barbara County. It is approximately 65 miles (105 km) northwest of Santa Barbara and 150 miles (240 km) northwest of downtown Los Angeles. Its estimated 2018 population was 108,470, making it the most populous city in the county and the Santa Maria-Santa Barbara, CA Metro Area. The city is notable for its wine industry and Santa Maria-style barbecue. Sunset magazine called Santa Maria "The West's Best BBQ Town". Santa Maria is located at 34°57′5″N 120°26′0″W / 34.95139°N 120.43333°W / 34.95139; -120.43333 (34.951377, -120.433...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Quality Audit Director jobs
$165,250 to $236,165
Santa Maria, California area prices
were up 2.5% from a year ago

Claims Quality Audit Director in Olympia, WA
Based on our compensation data, the estimated salary potential for Claims Quality Audit Director will increase 16 % over 5 years.
December 23, 2019