Clinical Specialist, Quality Management I

Ready To     ESSENTIAL DUTIES AND RESPONSIBILITIES: The Clinical Specialist, Quality Management & Training is a licensed clinical professional responsible for regulatory compliance, quality oversight, and workforce education across Utilization Management (UM), Case Management (CM), and Chronic Disease Management (CDM) programs. The role applies independent judgment and discretion to evaluate clinical systems, conduct internal and external audits, support accreditation readiness (e.g., NCQA/URAC), and implement quality and...