RN Quality Assurance Leader - Clinical Systems

CareOregon, Inc.; Portland, Northern (OR, KY); Hybrid; USD 141,000 - 172,000; Full time

Benefits offered by this job

Bonus opportunity

Total Rewards Program

Comprehensive benefits

Job summary

CareOregon, Inc. is seeking an RN Quality Assurance Manager for Clinical Systems to lead QA oversight for utilization management and clinical content testing. You will manage multiple teams, train staff, and collaborate with Clinical Operations to align with care strategies and regulatory requirements.

The role focuses on developing QA testing, reporting, and remediation workflows, ensuring quality standards are met, and communicating outcomes across the organization.

Qualifications

• Current unrestricted RN license for the State of Oregon.
• Minimum 5 years in health plan quality operations (QA, utilization management).
• Experience developing testing programs and quality assurance processes.

Responsibilities

• Develop and oversee department policies and procedures.
• Design, develop and update clinical content and testing.
• Create QA dashboards, reports and workflows.
• Lead training and onboarding of staff on QA processes.

Skills

Project management

Communication skills

Independent work

Team collaboration

Data analysis

Change management

Education

RN license

Tools

InterQual

MCG

Job description

CareOregon, Inc. is seeking an RN Quality Assurance Manager for Clinical Systems to lead QA oversight for utilization management and clinical content testing. You will manage multiple teams, train staff, and collaborate with Clinical Operations to align with care strategies and regulatory requirements.

The role focuses on developing QA testing, reporting, and remediation workflows, ensuring quality standards are met, and communicating outcomes across the organization.