CQE Manager I-Acupuncture

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a CQE Manager I-Acupuncture in United States.

This role offers a unique opportunity to blend clinical expertise with quality assurance in a fast-evolving healthcare environment. As a key contributor to clinical quality evaluation, you will ensure that acupuncture services meet established medical necessity and evidence-based standards. Working remotely, you will collaborate with cross-functional teams to support quality, compliance, and credentialing initiatives. The position combines independent decision-making with collaborative problem-solving, allowing you to influence care outcomes at scale. Ideal for experienced practitioners, this role emphasizes analytical thinking, clinical integrity, and continuous improvement. You will play a vital part in enhancing care quality while supporting practitioners and healthcare systems nationwide.

Accountabilities:

Manage and perform medical necessity reviews for acupuncture services, ensuring alignment with clinical guidelines and best practices
Conduct timely and consistent evaluations of requests from both network and non-network practitioners
Communicate clear, evidence-based clinical decisions and rationale to internal stakeholders and peers
Support credentialing processes, medical record reviews, and quality-of-care investigations as needed
Contribute to audits, regulatory reviews, and accreditation processes to maintain compliance standards
Collaborate with cross-functional teams to develop and refine clinical policies, protocols, and quality initiatives
Participate in workgroups, outreach activities, and continuous improvement efforts to enhance service delivery and clinical outcomes

Requirements:

Professional degree in Acupuncture from an accredited institution; advanced or specialized training is a plus
Active, unrestricted license to practice acupuncture in California, with willingness to obtain additional state licenses if required
Minimum of 5 years of clinical experience, with exposure to medical necessity review or quality evaluation preferred
Strong understanding of acupuncture guidelines, clinical best practices, and managed care environments
Excellent analytical and decision-making skills, with the ability to apply evidence-based criteria consistently
Strong communication and interpersonal skills, with the ability to explain clinical rationale clearly and professionally
Proficiency with standard business and clinical systems, including Microsoft Office and collaboration tools
Ability to work independently in a remote setting while maintaining high productivity and attention to detail

Benefits:

Competitive salary package based on experience and qualifications
Fully remote work environment with company-provided equipment
Health, dental, and vision insurance options
Retirement savings plan and financial wellness support
Paid time off, holidays, and work-life balance initiatives
Professional development and continuing education opportunities
Supportive and collaborative team culture focused on quality and innovation

Why Apply Through Jobgether?

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

#LI-CL1

USA Remote Jobs