Senior Quality Systems Specialist in United States

Become a part of our caring community The Senior Quality Improvement Professional leads efforts to improve clinical quality and provider performance for the Humana Healthy Horizons in South Carolina Medicaid Plan. You will develop and implement cross-functional quality improvement initiatives, evaluate business processes and performance outcomes, and drive sustainable, measurable improvements. Reporting to the Quality Improvement Director, you will collaborate with internal and external stakeholders to advance a provider-focused culture of quality and performance excellence. You will manage complex projects and analyze diverse data sources to identify opportunities, inform strategy, and support organizational objectives. The Senior Quality Improvement Professional leverages data to lead quality improvement initiatives, monitor performance metrics, and support provider performance enhancement. This role collaborates with provider-facing teams to implement targeted interventions, develop educational resources, and drive achievement of quality and member experience goals. The position leads and participates in multidisciplinary committees, provides strategic clinical guidance on quality initiatives, and influences business decisions through data-driven insights. Operating with a high degree of independence, the Senior Quality Improvement Professional manages complex projects, exercises sound judgment, and recommends solutions to advance organizational objectives. Essential Role Responsibilities The Senior Quality Improvement Professional is responsible for improving clinical quality and performance outcomes among South Carolina network providers. Key responsibilities include: Partner with Provider Engagement, Network, and Contracting teams to implement clinical quality improvement strategies including education, training and performanc

Senior Quality Operations Manager-Ultrasound — Reedsville, Pennsylvania, United States. Apply via Workday.

Become a part of our caring community The Telephonic Quality Outreach Professional supports the EPSDT program requirements in a telephonic outreach environment by evaluating member needs and helping families achieve or maintain an optimal state of wellness. The Telephonic Outreach Care Coach Professional 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically work on straightforward moderate complexity assignments that are routine and structured in nature. The Telephonic Quality Outreach Professional employs a variety of strategies and techniques to coordinate services and resources that facilitate HEDIS gap closure and improve pediatric health outcomes. The supervisor limits decisions to defined parameters around work expectations, quality standards, priorities and timing, and supervises closely and/or works within established policies/practices and guidelines with minimal opportunity for deviation. Position Responsibilities: Telephonic outreach to close HEDIS gaps for Medicaid pediatric population Assist members in addressing barriers to care, including scheduling challenges and transportation needs, to support access to primary care and overall well-being Collaborate with EPSDT Senior Quality Improvement Professional and Coordinator related to strategic outreach to maximize HEDIS outcomes Collaborate with other departments Provide vaccine awareness and education following Bright Futures and EPSDT preventive health guidelines Empower member independence through education and outreach that promote ongoing self-sufficiency in managing preventive and primary care needs Other responsibilities as assigned Use your skills to make an impact Required Qualifications Unrestricted Licensed Practical Nurse (LPN) in

At Gilead, we’re creating a healthier world for all people. For more than 35 years, we’ve tackled diseases such as HIV, viral hepatitis, COVID-19 and cancer – working relentlessly to develop therapies that help improve lives and to ensure access to these therapies across the globe. We continue to fight against the world’s biggest health challenges, and our mission requires collaboration, determination and a relentless drive to make a difference. Every member of Gilead’s team plays a critical role in the discovery and development of life-changing scientific innovations. Our employees are our greatest asset as we work to achieve our bold ambitions, and we’re looking for the next wave of passionate and ambitious people ready to make a direct impact. We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfil their aspirations. Join Gilead and help create possible, together. Job Description At Gilead our pursuit of a healthier world for all people has yielded a cure for hepatitis C, revolutionary improvements in HIV treatment and prevention as well as advancements in therapies for viral and inflammatory diseases and certain cancers. We set and achieve bold ambitions in our fight against the world’s most devastating diseases, united in our commitment to confronting the largest public health challenges of our day and improving the lives of patients for generations to come. The Director, Quality Assurance – GMP Operations provides senior Quality leadership and direct quality oversight of Manufacturing and

We anticipate the application window for this opening will close on - 8 Oct 2026 Careers that change lives start here. Medtronic is a global leader in healthcare technology with a Mission to alleviate pain, restore health, and extend life. Our 95,000 employees work across more than 150 countries to put patients first — developing innovative medical technologies that improve the lives of 72+ million patients each year. Your unique talents will help shape the future of healthcare while building a career grounded in purpose, growth, and impact. A Day in the Life At Medtronic, we bring bold ideas forward with speed and decisiveness to put patients first in everything we do. In-person exchanges are invaluable to our work. We’re working a minimum of 5 days a week onsite as part of our commitment to fostering a culture of professional growth and cross-functional collaboration as we work together to engineer the extraordinary. In this exciting role as a Senior Supplier Quality Engineering Manager, you will have responsibility for leading teams of Supplier Quality Engineers located at our Medtronic Tempe Campus. Your team will be accountable for changes to existing supplied products and processes, as well as oversight of performance, improvement activities, and quality risk reductions initiatives. Our Global Quality Strategy is rooted in the Medtronic Mission and our Quality Policy. Being a 'trusted partner' means always putting patient safety first, upholding product quality, and maintaining the highest ethical standards in our business relationships and programs. Responsibilities may include the following and other duties may be assigned. Manage a team of Supplier Quality Engineers that are responsible for ensuring delivery of quality components, materials, and services i

Strength in Trust OneTrust’s mission is to enable innovation through the responsible use of data and AI. We believe that ensuring data is trusted shouldn’t slow teams down—it should accelerate what’s possible. This led us to develop the first technology platform for responsible data use in 2016. Today, with AI representing the latest and most impactful expansion of data yet, OneTrust is once again redefining what responsible innovation looks like. OneTrust, the AI‑Ready Governance Platform™, unifies regulatory intelligence, automation, and connected governance workflows so businesses can continue to move at the speed of AI while ensuring good governance to prevent data misuse at scale. Trusted by thousands of organizations worldwide, OneTrust is shaping the future where trusted data becomes a transformative force for business and society. The Challenge OneTrust is building the AI-Ready Governance Platform™ to help organizations build trust, manage risk, and use data and AI responsibly. Our platform brings together privacy automation, consent and preferences, data use governance, AI governance, tech risk and compliance, and third-party management across connected, cloud-based workflows. As a Senior Staff Quality Engineer, SDET, you will define the quality engineering strategy that enables OneTrust to scale this platform with confidence. You will shape how we validate integrated customer journeys, protect trust-critical data and workflows, and release reliable capabilities across a broad product portfolio. This role is for an experienced technical leaderwho can solve significant, unique problems requiring independent judgment, evaluation of intangible factors, and the creation of methods and procedures for specialized, high-stakes initiatives. Your Mission Quality Strategy for Trust-Critical Products Define automation architecture, quality strategy, and release-validation practices acro

Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: CIG Senior Specialist Quality Assurance Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: Career development with an international company where you can grow the career you dream of. Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. An excellent retirement savings plan with a high employer contribution Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity In this role, you will lead cross-functional teams in the execution of complaint investigations, ensuring activities are completed in a timely, compliant,

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. Cortex Code is Snowflake’s coding agent for building with data. It ships inside the platform that thousands of the world’s largest enterprises — including a large share of the Forbes Global 2000 — run their data on, which means the quality of this agent is felt by the data teams behind a meaningful slice of the global economy. We are taking coding agents from impressive demos to tools Data Science and Engineering teams depend on every day, and we hold them to a rigorous, public bar: see our data engineering agent benchmark . About the Role This is a measurement-first role that owns the quality and efficiency of Cortex Code end to end: how good the agent is, how much it costs to run, and how reliably it behaves in production. You will take agents from research capability to real, measurable user value — turning fuzzy “the agent feels worse” signals into hard metrics, running the experiments that move them, and shipping the changes that stick. You will work on a small, high-powered modeling and infrastructure team where your work reaches every developer building on Snowflake. What you will do in this role Take agents from prototype to production: design and refine agent behaviors for real coding and data-engineering workflows, and make them reliable enough to depend on. Own a

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. At Snowflake, we are building a high-impact team to help the world's most innovative companies unlock the power of AI. As a Senior Forward Deployed Engineer, Applied AI on our Cortex AI team, you will be a hands-on technical leader and trusted partner to our most strategic customers. You will own the end-to-end delivery of enterprise AI programs, leading a team of 2–4 engineers while staying deeply technical yourself. You will set the technical direction for your customer engagements, mentor your team, and serve as the senior technical voice at the intersection of product, engineering, and customer success. IN THIS ROLE AT SNOWFLAKE, YOU WILL: Lead Customer Programs : Own the full lifecycle of complex, multi-engineer AI engagements – from scoping and architecture through deployment, monitoring, and handoff. Be accountable for delivery quality and customer outcomes for the projects you lead. Own AI Quality : Define what "good" means for each engagement. Translate ambiguous customer goals into measurable quality metrics, evaluation frameworks, and golden datasets – then run systematic eval loops to hill-climb on agent quality, catch regressions before customers do, and continuously raise the bar on accuracy, faithfulness, and safety. Set the standard for how the team measures

The Senior RMA Customer Experience Manager will work with the key customer account team leads to ensure customers have timely case updates. The position has to decide on fulfilment priority based on Service Level Agreements and track regional buffer stock. The manager needs to work with account leads to track the impact of open RMAs on customer datacenter capacity, so as to make allocation decisions. What you’ll be doing: Customer Satisfaction: Manage RMA cases and lead all aspects of replacement part fulfillment to clear the open RMA backlog per Service Level Agreements. Work with account teams to prioritize backlog in case of supply constraints. Case Management: Attend customers meeting, provide accurate and up-to-date information on case status, track of customer feedback and develop strategies to improve the overall customer experience. Metrics and Improvement: Generate case management metrics and analyze data to identify process improvement opportunities. Publish weekly status updates on open RMAs – supply commits, ready for pickup, shortage alerts. Collaboration: Work closely with quality and manufacturing teams to effectively communicate RMA updates and statuses to customer account teams. Facilitate seamless information flow between teams to provide exceptional customer support. Uptime and Buffer Stock: Track key customer installations uptime and work with planning team to maintain buffer stock near customer sites to proactively address potential supply shortages. Supply Allocation: Collaborate with production and repair factory planners to map out supply allocations for the open RMA backlog. Optimize resource allocation for timely resolution. Serve as Lead: Trainer and support for other case managers on program, process, customer interface and working internally as new programs develop for NPI and implemented into our global customer service team. What we need to see:

What You Will Achieve As a Senior Scientist, you will be at the center of our operations and you’ll find that everything we do, every day, is in line with an unwavering commitment to quality. You will be recognized as a technical expert and a scientific contributor. With your deep knowledge of the discipline, you will be an active team member whose decisions impact the projects. You will perform qualitative and quantitative analyses of organic and inorganic compounds to determine chemical and physical properties during chemical syntheses, or drug product development process. You will be using your scientific judgment to adapt standard methods and techniques by applying prior work experience. You will be forecasting and planning resource requirements for your project team. Your creativity in developing novel processes and new ideas will be used frequently. You will undertake mentoring activities to guide team members. It is your innovative scientific temperament that will help in making Pfizer ready to achieve new milestones and help patients across the globe. How You Will Achieve It This colleague will be responsible for developing analytical strategies in support of pharmaceutical drug substance and/or drug products during all development phases, including supporting manufacturing process development, developing, validating and transferring analytical methods, designing stability studies for shelf life assignments, and developing impurity control strategies. Collaborates with colleagues and subject matter experts to assess the most appropriate analytical approach to support project activities, including use of computational predictive tools, modelling software and data visualization tools where appropriate. Perform lab work and delegate responsibilities and review peer lab work as appropriate, Through effective communicat

Become a part of our caring community With over 10 million sales interactions annually, Humana understands that while great products are important, it’s the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. This role is field based, and you will be out and about in the field in the Oklahoma, NW AR and Central AR markets working with your team and meeting members face to face. You must reside in the Oklahoma City, OK area or be willing to relocate. In this field position, you will; coach, mentor, educate, motivate and train a team of sales individuals. The Senior Manager, Medicare Sales, must have a solid understanding of the market they serve, how to resolve operational problems and provide creative solutions to increase sales while following CMS guidelines. This role also involves cultivating, maintaining, and building relationships with Humana’s customers, both internal and external business partners, along with the community we serve through telephonic, virtual, and face-to-face interactions with individuals and groups. Other responsibilities include developing marketing budgets, and looking for branding opportunities. Benefits include: Medical, Dental, Vision, and a variety of other supplemental insurances Paid Time Off (PTO) and Paid Holidays 401(k) retirement savings plan with a company match Tuition reimbursement and/or scholarships for qualifyi

This is where your work makes a difference. At Baxter, we believe every person—regardless of who they are or where they are from—deserves a chance to live a healthy life. It was our founding belief in 1931 and continues to be our guiding principle. We are redefining healthcare delivery to make a greater impact today, tomorrow, and beyond. Our Baxter colleagues are united by our Mission to Save and Sustain Lives. Together, our community is driven by a culture of courage, trust, and collaboration. Every individual is empowered to take ownership and make a meaningful impact. We strive for efficient and effective operations, and we hold each other accountable for delivering exceptional results. Here, you will find more than just a job—you will find purpose and pride. Your role at Baxter: Develop and implement the human resources strategy for Front Line Care in support of the business unit’s growth, innovation, quality and margin objectives and the desired Baxter culture. Serve as the principal HR advisor and coach to the President of Front Line Care and the FLC leadership team on organizational design, workforce planning, talent management and development, leadership effectiveness, total rewards, employee relations and change management. As a member of the Baxter HR Leadership Team, contribute to the shaping of enterprise people strategy, standards and HR operating model — not only its adoption within FLC. Success in this role requires strategic oversight and design capability coupled with the credibility and appetite to drive tactical execution personally and through a team, in a matrixed, highly regulated, multi-site environment. Organizational Relationships Reports to: Chief Human Resources Officer, Baxter International. Business Partner for President, Front Line Care. <l

At Snowflake, we are powering the era of the agentic enterprise. To usher in this new era, we seek AI-native thinkers across every function who are energized by the opportunity to reinvent how they work. You don’t just use tools; you possess an innate curiosity, treating AI as a high-trust collaborator that is core to how you solve problems and accelerate your impact. We look for low-ego individuals who thrive in dynamic and fast-moving environments and move with an experimental mindset — who rapidly test emerging capabilities to discover simpler, more powerful ways to deliver results. At Snowflake, your role isn't just to execute a function, but to help redefine the future of how work gets done. The Mission The Global Revenue Enablement (GRE) organization exists to equip every audience in our ecosystem — field sellers, technical specialists, and partners — with the clarity, content, and skills they need to execute with speed and consistency. This Program Manager sits within the PMO + Data team and owns the design, execution, and continuous improvement of Snowflake's Authorized Training Partner (ATP) program. You will build and scale a certified partner and instructor network that extends Snowflake's educational reach into markets and segments the core team cannot serve directly — while protecting brand integrity and learner experience at every touchpoint. You are the DRI for training partner program success metrics. You'll design the operating model, set quality standards, and continuously optimize how the program runs. The first 6 months will include a heavier focus on learning the team's operations and designing workflow improvements; afterward, the role shifts more toward partner program ownership and strategic growth. Key Responsibilities Partner Program Design & Ownership Own execution and continuous improvement of the Authorized Training Partner (ATP) program: manage partner onboarding, certification, quality standards, and performance management within e

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Review and adjust SF (self-funded), FI (fully insured), Reinsurance, and/or RX claims; adjudicates complex, sensitive, and/or specialized claims in accordance with claim processing guidelines. Process provider refunds and returned checks. May handle customer service inquiries and problems. Perform adjustments across all dollar amount level on customer service platforms by using technical and claims processing expertise. Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and apply all cost containment measures to assist in the claim adjudication process. Performs claim re-work calculations. Follow through completion of claim overpayments, underpayments, and any other irregularities. Process complex non-routine Provider Refunds and Returned Checks. Review and interpret medical contract language using provider contracts to confirm whether a claim is overpaid to allocate refund checks. Handle telephone and written inquiries related to requests for pre-approvals/pre-authorizations, reconsiderations, or appeals. Ensures all compliance requirements are satisfied and that all payments are made following company practices and procedures. Review and handle relevant correspondences assigned to the team that may result in adj