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C2C Innovative Solutions Inc.
FL, United States (remote)
10 days ago
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Birmingham, AL (on-site)
30+ days ago
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Region V Services
Lincoln, NE, United States (on-site)
1 day ago
C2C Innovative Solutions Inc.
Florida, United States (remote)
10 days ago


Please make sure your application is complete, including your education, employment history, and any other applicable sections. Initial screening is based on the minimum requirements as defined in the job posting, such as education, experience, licenses, and certifications. Your experience should also address the knowledge, skills and abilities needed for the role. Incomplete applications will not be considered.

*This position is located Remote Anywhere US*

Position Purpose:

Performs advanced (senior-level) quality assurance and supervisory work.  Ensures decision makers adjudicate cases accurately by performing quality audits, reviews, and publishing audit results and conducting meetings, providing coaching, and training on quality.  Works under limited supervision, with considerable latitude for the use of initiative and independent judgement. 

Essential Responsibilities:

  • Oversees, plans, and monitors the quality assurance program.
  • Oversees, plans, and audits to ensure timeliness, accuracy, and consistency in reconsideration/dispute resolution decisions.
  • Oversees, develops, and identifies individual and collective training opportunities based on audit findings and/or data analysis of reconsiderations/dispute resolution decisions to help improve individual and corporate quality.
  • Oversees, plans, prepares, reviews and analyses data to identify problems, trends and improvement opportunities.
  • Oversees, plans, and reviews reopened cases and cases from the problem log in order to identify trends and needs for improvement.


C2C offers an excellent benefits package, including:

  • Medical, dental, vision, life, accidental death and dismemberment, and short and long-term disability insurance
  • Section 125 plan
  • 401K
  • Competitive salary
  • License/credentials reimbursement
  • Tuition Reimbursement


EOE Minorities/Females/Vet/Disability


Minimum Qualifications


  • Associate's degree or 60 or more credit hours towards a Bachelor’s degree from an accredited college or university in healthcare or related discipline
    • Additional Medicare appeals or clinical experience in a healthcare setting may be substituted for Associate’s degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the prorated part-time equivalent.)


  • Five (5) years medical dispute, Medicare appeals or clinical experience in a healthcare setting
  • Three (3) years management or supervisory
  • Three (3) years quality assurance oversight for work directly related to the Medicare program (e.g., quality assurance oversight at the QIC, MAC, or other equivalent experience) (Required per contract)
  • Two (2) years of training
  • Medicare Part B
  • Healthcare Professional with demonstrated experience writing or making medical necessity decisions
  • Nursing, Physical Therapy, Respiratory Therapy or Occupational Therapy experience

Job Information

  • Job ID: 70831175
  • Workplace Type: Remote
  • Location:
    Florida, United States
  • Company Name For Job: C2C Innovative Solutions Inc.
  • Position Title: Quality Assurance Manager I- Remote, Anywhere US
  • Industry: Non-Profit / Charity
  • Job Function: Other
  • Job Type: Full-Time
  • Job Duration: Indefinite
  • Min Education: Associates Degree
  • Min Experience: 5-7 Years

Please refer to the company's website or job descriptions to learn more about them.

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