Qlarant Jobs in United States

· Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed ca ...

· Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed ca ...

Performs project management activities to help facilitate the successful implementation and completion of quality improvement projects in various delivery settings. · Conducts baseline analysis of current practices and utilizes quality improvement tools to identify opportunities ...

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Coordinates efforts providing baseline support to project teams against key deadlines and requirements. · ...

Owns responsibility for ensuring the optimal performance of the medical review division continuously monitoring and analyzing performance metrics to identify opportunities improving processes procedures Assists supports Director Medical Operations in operations administration con ...

· Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed ca ...

Job Title · Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, m ...

About Company: · Qlarant · is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization re ...

Nurse Specialist II reviews medical records and claims data to ensure proper guidelines have been followed and assesses for potential overpayment and fraud. · ...

· Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed ca ...

Performs in-depth evaluation and makes field level judgments related to complaints and investigative leads of potential fraud investigations (e.g. Medicare and/or Medicaid) that meet established criteria for referral to the appropriate agency(ies) for administrative action or law ...

Coordinates efforts providing baseline support to project teams against key deadlines and requirements. Maintains project documentation, tracking progress, and identifying potential risks or issues that may impact project delivery, escalating concerns to management for review and ...

Oversees audits/investigations and audit/investigation workload. · Prior supervisory experience preferredCertified Fraud Examiner or Accredited Healthcare Anti-fraud Investigator Certification preferred ...

· Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed ca ...

Serves as an entry level professional who develops baseline plans for ensuring the integrity and accuracy of claims processes and protocols Collects data for auditsinvestigations into claims utilizing a combination of analytical skills and attention to detail reviewing documentat ...

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care ...

The Auditor/Investigator II plays a critical role in ensuring organizational compliance and integrity by conducting thorough audits and investigations into financial records, operational processes, and regulatory adherence. · The role requires analyzing complex data sets and docu ...

Monitors the processing and reconciliation of incoming electronic medical records. · ...

Facilitates routine evaluations to assess the extent to which individuals with intellectual developmental disabilities (IDD) are receiving customized support and services tailored to their unique needs and specific situations. · ...