Quality Improvement Director - Healthcare jobs in Tulsa, OK

Quality Improvement Director - Healthcare leads and directs process and overall quality improvement activities that produce better patient care and more efficient operations. Develops programs to review and evaluate patient care and outcomes. Being a Quality Improvement Director - Healthcare implements a strategy and plans for a quality improvement function within the facility in collaboration with the administrative and clinical leaders of the hospital. Tracks and presents results of improvement efforts and ongoing measures of clinical processes to management. Additionally, Quality Improvement Director - Healthcare requires a bachelor's degree. Typically reports to top management. The Quality Improvement Director - Healthcare typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. To be a Quality Improvement Director - Healthcare typically requires 3+ years of managerial experience. (Copyright 2024 Salary.com)

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Quality Improvement - Grievance & Appeals Coordinator 195-1022
  • CommunityCare
  • Tulsa, OK FULL_TIME
  • JOB SUMMARY: Responsible for all written inquiries from members seeking resolution through the grievance and appeals process.   KEY RESPONSIBILITIES: Researches member issues and prepares grievance and appeals information for each level of the appeal process. Responsible for adhering to established grievance and appeals timeframes. Assures compliance with Federal, State and Accreditation regulations.  Receives and responds to member and/or provider written and oral complaints and requests in accordance with CommunityCare's grievance and appeals procedures. Ensures appropriate file documentation that demonstrate process steps.  Interacts with Medical Management, Member Services, Claims, Pharmacy, Provider Services as well as Senior Management to resolve issues. Interacts with members, providers, and attorneys who represent the member regarding the grievance and appeals process. Interacts with Center for Medicare and Medicaid Services (CMS) and MAXIMUS Federal Services as indicated. Ensures the grievance and appeals electronic tracking system (GATS) is populated correctly and completely for each case. Participates in the audit process. Notifies members and/or providers in writing of the decision made at each level of the appeal process. Coordinates with the Claims, Pharmacy helpdesk and or Medical Management to ensure that authorization is obtained and claim payment is processed, if indicated.  Prepares grievance and appeal files for audit. Assist Supervisor with special projects and CMS quarterly reports as it relates to Grievance and Appeals.  Explains policies, procedures, available benefits and service options to members and/or providers related to the grievance and appeals process. For inquiries forwarded from the Department of Insurance, adheres to all specified communication and timeframe requirements. Documents accordingly in the file. Work may involve dealing with members who are disgruntled or upset. Perform other duties as assigned. QUALIFICATIONS: Customer service experience in managed care, insurance or healthcare environment required. Successful completion of Health Care Sanctions background check. Possess strong oral and written communication skills. Ability to work on multiple tasks. Proficient in Microsoft applications. Highly organized and attentive to detail. EDUCATION/EXPERIENCE: High school diploma or equivalent PLUS 5 years related experience OR Associates degree plus 1 year of related experience required. Related experience consists of customer service, member service or claims processing in an insurance environment. Managed care experience preferred.
  • 5 Days Ago

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Quality Improvement - Clinical Coding & Compliance Analyst 195-2013
  • CommunityCare
  • Tulsa, OK FULL_TIME
  • JOB SUMMARY: Responsible for the review, analysis, reporting and follow-up of risk adjustment and clinical coding functions to support the accurate representation of the member’s clinical health statu...
  • 14 Days Ago

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Quality Improvement - Member Engagement Specialist 195-1017
  • CommunityCare
  • Tulsa, OK FULL_TIME
  • JOB SUMMARY: Responsible for completing out-bound calls and other member outreach opportunities to select members and documenting efforts. This role spends 100% of time on quality program activities. ...
  • 14 Days Ago

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Quality Improvement - Member Engagement Specialist 195-1008
  • CommunityCare
  • Tulsa, OK FULL_TIME
  • JOB SUMMARY: Responsible for completing out-bound calls and other member outreach opportunities to select members and documenting efforts. This role spends 100% of time on quality program activities. ...
  • 14 Days Ago

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Audit - Director - Healthcare - OK
  • FORVIS
  • Tulsa, OK FULL_TIME
  • General information Name Audit - Director - Healthcare - OK Posting Title Audit Director | Healthcare Ref # 2227623 Date Published Tuesday, May 30, 2023 City Tulsa State Oklahoma Country United States...
  • 2 Days Ago

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Director of Quality
  • TAT Technologies Ltd
  • Tulsa, OK FULL_TIME
  • The overall objective for the Quality is to lead the Quality and Inspection Team in developing and maintaining a system to ensure all products supplied by the organization to meet customer specificati...
  • 8 Days Ago

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0 Quality Improvement Director - Healthcare jobs found in Tulsa, OK area

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Inventory & Purchasing Analyst
  • System One Holdings, LLC
  • Tulsa, OK
  • System One has partnered with a growing healthcare organization that is seeking a qualified Inventory and Asset Manageme...
  • 4/26/2024 12:00:00 AM

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Nurse Manager / Cath Lab
  • Hillcrest Medical Center
  • TULSA, OK
  • Overview Join our team as a full-time, day shift, Cath Lab Manager in Tulsa, OK. You may be eligible for up to an $15,00...
  • 4/24/2024 12:00:00 AM

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RN Registered Nurse
  • The Villages at Southern Hills
  • Tulsa, OK
  • The Villages at Southern Hills - RN - Registered Nurse The Villages at Southern Hills Tulsa, OK The Villages at Southern...
  • 4/24/2024 12:00:00 AM

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Registered Dietitian
  • Amergis
  • Tulsa, OK
  • Amergis Healthcare Staffing is looking for Registered Dietitian Coordinator all phases of nutrition care including nutri...
  • 4/24/2024 12:00:00 AM

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Director of Critical Care
  • Hca Healthcare
  • Tulsa, OK
  • HCA Healthcare Director of Critical Care Austin , Texas Apply Now Are you ready to manage in a new era as a Director of ...
  • 4/23/2024 12:00:00 AM

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Physician - Cardiac Critical Care
  • Ascension Health
  • Tulsa, OK
  • **Details** + **Specialty: Critical Care** + **Schedule: 7 on/7 off** + **EMR System: Cerner** + **Facility: Ascension S...
  • 4/22/2024 12:00:00 AM

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Lead Server
  • Cedarhurst Senior Living
  • Tulsa, OK
  • Can you be a real, true friend? Is it your nature to be open, listen deeply, know your heart, respond genuinely, and car...
  • 4/22/2024 12:00:00 AM

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Senior Sales Manager, Multifamily - Cox Communities
  • Cox Communications, Inc.
  • Tulsa, OK
  • Company Cox Communications, Inc. Job Family Group Sales Job Profile Sr Manager, Direct Sales MDU New Build - CCI Managem...
  • 4/22/2024 12:00:00 AM

Tulsa is located in the northeastern corner of Oklahoma, 99 miles (159 km) northeast of Oklahoma City; situated between the edge of the Great Plains and the foot of the Ozarks in a generally forested region of rolling hills. The city touches the eastern extent of the Cross Timbers, an ecoregion of forest and prairie transitioning from the drier plains of the west to the wetter forests of the east. With a wetter climate than points westward, Tulsa serves as a gateway to "Green Country", a popular and official designation for northeast Oklahoma that stems from the region's green vegetation and r...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Quality Improvement Director - Healthcare jobs
$107,363 to $146,155
Tulsa, Oklahoma area prices
were up 1.2% from a year ago

Quality Improvement Director - Healthcare in New Bedford, MA
Quality improvement is meant for enhancing safety, effectiveness, and efficiency.
February 14, 2020
Quality Improvement Director - Healthcare in Temple, TX
Once quality improvement leaders establish a vision, they need to communicate the vision to physicians and staff to gain buy-in.
February 14, 2020
Quality Improvement Director - Healthcare in Duluth, MN
"In general, we don't have a culture of feeling comfortable discussing opportunities for improvement, especially when it comes to the way relationships can be managed," Ms.
January 30, 2020