In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
In support of the CMO, the Associate Medical Director is responsible for the administration of ... quality assurance programs. In coordination with the CMO and Directors of Health Management and QI ...
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Field Application Engineer '27
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Quick apply
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Business Analyst - Lending & PM Tools
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Outreach Prog Assoc Dir- Wisconsin Child Welfare Professional Development System (WCWPDS)
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Outreach Program Associate Director Job Summary: The Associate Director works closely with the ... and quality assurance of professional development resources for Wisconsin child welfare ...
Remote Quality Assurance Associate information
What is the difference between Remote Quality Assurance Associate vs Remote Software Tester?
| Aspect | Remote Quality Assurance Associate | Remote Software Tester |
|---|---|---|
| Credentials | Typically requires a QA certification or related degree | Often requires a QA or testing certification, or relevant technical background |
| Work Environment | Collaborates with development teams, reviews requirements, performs testing | Focuses on executing test cases, identifying bugs, and reporting issues |
| Industry Usage | Common in software, tech, and digital product companies | Widely used in software development and IT industries |
The Remote Quality Assurance Associate and Remote Software Tester roles share many similarities, including required certifications and work environments. Both focus on testing software to ensure quality, often within the tech industry. However, QA Associates may have broader responsibilities, including process improvement and documentation, while Software Testers primarily execute test cases and report bugs. Understanding these nuances helps job seekers identify the best fit for their skills and career goals.
What are the most commonly searched types of Remote Quality Assurance jobs in Wisconsin?
The most popular types of Remote Quality Assurance jobs in Wisconsin are:
What are popular job titles related to Remote Quality Assurance Associate jobs in Wisconsin?
For Remote Quality Assurance Associate jobs in Wisconsin, the most frequently searched job titles are:
What job categories do people searching Remote Quality Assurance Associate jobs in Wisconsin look for?
The top searched job categories for Remote Quality Assurance Associate jobs in Wisconsin are:
What cities in Wisconsin are hiring for Remote Quality Assurance Associate jobs?
Cities in Wisconsin with the most Remote Quality Assurance Associate job openings:
Full-time
Re-posted 10 days ago
Job description
In support of the CMO, the Associate Medical Director is responsible for the administration of procedures, protocols, and standards regarding the efficiency and quality of the health care delivered to Network Health (NH) members. This individual will be chair of at least 3 committees related to quality and accreditation.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel is required occasionally for the position.
Hours: 0.3 FTE, 24 hours per pay period, 8am - 5pm Friday through Sunday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
Job Requirements:
Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required). Travel is required occasionally for the position.
Hours: 0.3 FTE, 24 hours per pay period, 8am - 5pm Friday through Sunday
Check out our 2025 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.
Job Responsibilities:
- Assist the CMO with monitoring availability, appropriateness, and necessity of care rendered by participating providers and by out-of-plan providers
- Participate in oversight and clinical decision making of the UM program, including but not limited to rendering denial determinations for services not considered medically necessary or experimental/investigation/unproven in accordance with regulatory and quality standards
- Contribute to the development of quality care guidelines, internal peer review procedures, and the evaluation of medical care evaluation studies under the NHP quality assurance programs. In coordination with the CMO and Directors of Health Management and QI and Disease Management, share responsibility for the development and continued evaluation of utilization review and quality assessment processes
- Provide medical consultation as requested for:
- Medical/legal issues
- Member grievance procedures
- Development and implementation of new benefit packages and the interpretation of covered benefits in NHP contracts
- Medical issues related to contract negotiations with health care providers
- Determining if services to members/enrollees meet medical criteria
- Promote positive relationship between NHP and medical community
- Serve as liaison between NHP and providers regarding matters of medical policy and medical administration
- Serve as spokesperson for NHP in the medical community and maintains appropriate contact with professional health care organizations
- Participates in the ongoing recruitment of plan physicians.
- Respond to physicians and other provider inquiries and complaints within established guidelines of the Executive Committee and Board of Directors
- Assist in the development of appropriate medical guidelines and parameters for claims review
- Assist in the training of NHP staff on matters relating to medical guidelines
- Oversight responsibility for monitoring and evaluating Medicare Special Needs Plan Model of Care effectiveness
- Perform second level review of provider appeals and disputes
- Serve on committees as coordinated with the CMO
- Assist in strategic planning targeted towards plan growth initiatives
Job Requirements:
- Doctor of Medicine (MD or DO), licensed in the state of Wisconsin without restriction
- Member in good standing of the local medical community. An active practitioner of medicine in the NHP service areas
- Must possess a thorough knowledge of the health professional and facilities and standards of practice of medicine in NHP's service area
- Must possess sufficient medical experience and other experience, including knowledge of the Medicare program, to review organization determinations involving medical necessity
- Board certified in an ABMS medical specialty required
Network Health is an Equal Opportunity Employer
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
About Network Health
Sourced by ZipRecruiter
Industry
Insurance services
Company size
201 - 500 Employees
Headquarters location
Menasha, WI, US
Year founded
1982