RN Licensed Quality Program Manager

A company is looking for a UM Operations Quality Program Manager.

Key Responsibilities

Oversee the design, testing, and implementation of AI tools for clinical operations

Lead quality and audit programs to ensure compliance with regulatory guidelines

Analyze operational performance metrics to identify inefficiencies and drive improvements

Required Qualifications

Active RN or LPN license with 5+ years of UM experience

3+ years of experience in UM quality, audit, or program management

In-depth knowledge of UM processes and CMS regulations

Experience implementing AI or automation tools in healthcare operations

Strong analytical and project management skills