%20(1).png){kind=small}
Talent. Solutions. Results.
What This Track Involves
HealthSkil's QIO and Medical Assistance Program Integrity team operates as a CMS-certified QIO-like Entity, working directly with the Pennsylvania Department of Human Services to improve the quality of care delivered through Medicare, Medicaid, and the state's Medical Assistance program.
In practice, that means our team reviews care across hospitals, hospice settings, long-term living facilities, and managed-care plans to identify quality improvement opportunities, audit compliance with federal standards, and advocate for patients who may not be getting the care they deserve. We don't deliver direct patient care in these roles — we make sure the systems delivering that care are doing it well.
This is mission-critical work. Pennsylvania serves millions of Medicaid and Medicare beneficiaries, and the integrity of those programs depends on the people in this track. RNs in QIO and Program Integrity bring their clinical expertise to bear on chart reviews, peer reviews, care coordination, and program audits. Auditors and compliance specialists ensure documentation, billing, and care delivery meet federal and state standards.
Most positions in this track are based in Pennsylvania, with strong remote and hybrid flexibility. Hubs include Harrisburg, Philadelphia, and Pittsburgh, though many roles can be performed from anywhere in the state. Our 5-year Pennsylvania state contract runs through January 2031, providing exceptional career stability for clinicians who want to step away from bedside care without leaving healthcare entirely.
Typical Roles in This Track
HealthSkil regularly hires for the following position types within QIO and Program Integrity:
RN – Medical Assistance Expert
RN – Long Term Living Expert
RN – Hospice Expert
RN – Med-Surg Hospitalization Expert
HSS Clinical Coordinator RN – High-Risk Maternity
Quality Improvement Data Specialist
Public Service Remote Workload Manager
Remote Oversight & Advocacy Specialist
-
RNs with active Pennsylvania licensure looking for non-bedside work
-
Healthcare professionals with utilization review, case management, or chart review experience
-
Detail-oriented clinicians who enjoy data and documentation
-
Anyone with prior QIO, Medicaid, or managed care plan experience
-
Strong communicators comfortable working remotely or hybrid
Who Thrives in This Track?
Why HealthSkil for QIO Careers
CMS-Recognized QIO-like Entity
Officially designated by the Centers for Medicare & Medicaid Services to perform quality improvement work in Pennsylvania.
Long-Term State Contract
5-year Pennsylvania state contract running through January 2031 — exceptional career stability.
Remote & Hybrid Flexibility
Most QIO roles can be performed from anywhere in PA, with optional hub access in Harrisburg, Philadelphia, or Pittsburgh.
30+ Year Track Record
HealthSkil and its parent organization have been improving Pennsylvania healthcare quality for three decades.