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Cphq Jobs in Ohio (NOW HIRING)

Molina Healthcare

Medical Review Nurse (RN)

Columbus, OH · On-site

$29.05 - $56.64/hr

... CPHQ), or other health care certifications. • Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. • Billing and coding experience. To all current Molina ...

Heart of Ohio Family Health

Grant Writer

Columbus, OH · On-site

$64K - $91K/yr

Certifications such as CPHQ and Lean Six Sigma are beneficial, but not required. Experience: * Industry Experience - Strongly preferred at least one year working in healthcare or working on grants.

Molina Healthcare

Medical Review Nurse (RN)

Columbus, OH · Remote

... CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If ...

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See Ohio salary details

$29.5K

$119.4K

$203K

How much do cphq jobs pay per year?

As of Aug 11, 2026, the average yearly pay for cphq in Ohio is $119,408.00, according to ZipRecruiter salary data. Most workers in this role earn between $86,500.00 and $143,600.00 per year, depending on experience, location, and employer.

Is the Certified Professional in Healthcare Quality (CPHQ) certification worth it?

The CPHQ certification is valuable for healthcare quality professionals, as it demonstrates expertise in quality management, patient safety, and performance improvement. It can enhance job prospects, credibility, and earning potential in healthcare settings. However, its worth depends on individual career goals and the specific requirements of employers in the healthcare industry.

What are the main responsibilities and daily tasks of a CPHQ in a typical healthcare setting?

As a CPHQ, your day-to-day responsibilities often involve analyzing clinical and operational data, identifying areas for quality improvement, facilitating performance improvement projects, and ensuring compliance with healthcare regulations and accreditation standards. You will collaborate closely with clinical staff, administrators, and quality teams to develop and implement best practices that enhance patient safety and care outcomes. Responsibilities may also include staff education on quality initiatives, conducting audits, and preparing reports for leadership or regulatory bodies. This role is dynamic and highly collaborative, making it ideal for individuals who enjoy problem-solving and driving positive organizational change.

What are the key skills and qualifications needed to thrive in the CPHQ position, and why are they important?

To thrive as a CPHQ (Certified Professional in Healthcare Quality), you need a solid foundation in healthcare quality management, process improvement, and data analysis, typically supported by a healthcare-related degree and CPHQ certification. Familiarity with quality measurement systems such as HEDIS, NCQA, and various healthcare analytics tools is important. Strong communication, critical thinking, and teamwork skills help CPHQs effectively lead initiatives and collaborate across departments. These competencies ensure successful implementation of quality improvement programs, regulatory compliance, and the promotion of patient safety and organizational excellence.

What is a CPHQ?

A CPHQ (Certified Professional in Healthcare Quality) job involves overseeing and improving healthcare quality and patient safety. Professionals in this role analyze data, implement quality improvement initiatives, and ensure compliance with healthcare regulations. They work in hospitals, insurance companies, and other healthcare organizations to enhance care efficiency and effectiveness. CPHQs may also develop policies, conduct staff training, and collaborate with leadership to drive continuous improvement.

What can you do with CPHQ certification?

The CPHQ (Certified Professional in Healthcare Quality) certification demonstrates expertise in healthcare quality management, patient safety, and performance improvement. It qualifies professionals for roles such as healthcare quality manager, compliance officer, or patient safety coordinator, often involving data analysis, process improvement, and regulatory adherence.
What are the most commonly searched types of Cphq jobs in Ohio? The most popular types of Cphq jobs in Ohio are:
What are popular job titles related to Cphq jobs in Ohio? For Cphq jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Cphq jobs in Ohio look for? The top searched job categories for Cphq jobs in Ohio are:
What cities in Ohio are hiring for Cphq jobs? Cities in Ohio with the most Cphq job openings:
Cphq jobs near you
Infographic showing various Cphq job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $119,408 per year, or $57.4 per hour.

RN UTILIZATION SPECIALIST - DENIALS & APPEALS

Southwest General

Middleburg Heights, OH

Full-time

Re-posted 9 days ago

Southwest General Health Center rating

6.9

Company rating: 6.9 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

551st of 1,056 rated hospitals

Job description

Summary

  • POSITION INFORMATION
    • Position summary:Utilization Specialist Denials & Appeals will support the clinical staff, utilization specialists, denials management, and the Physician Advisors. This role will review patient medical records to ensure accurate documentation, proper level of care, and compliance with regulatory standards to prevent denials in the acute care setting.
  • MINIMUM QUALIFICATIONS
    • Education:
      • Bachelors degree in nursing (BSN) preferred

    • Required length and type of experience:
      • Minimum of three years of clinical nursing experience, with strong preference for experience in case management, utilization review, or CDI, in the acute care setting.
      • Knowledge of ICD-10 coding guidelines, Medicare/Medicaid regulations, MCG, Cerner (EMR), MS office tools, such as Word, Excel, PowerPoint.
      • Ability to analyze complex medical records and identify gaps in documentation.
      • Strong verbal and written communication skills to interact with physicians and insurance payers.
      • Ability to collaborate with diverse teams including nurses, physicians, and administrative staff.

    • Required licensure, certification or registry:
      • Current RN License by the Ohio State Board of Nursing.
      • Preferred certification(s): ACM/ACM-RN, CCM, CMAC, CPHQ.

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