- Evolent (Hartford, CT)
- …Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ( NCQA ) guidelines. + Aids and acts as a resource to Initial Clinical ... Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + Participates in on-going training per inter-rater reliability process. + May assist the Senior Medical Director… more
- Moses/Weitzman Health System (Hartford, CT)
- …center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA , respectively. We deliver more than 600,000 patient visits per year from primary ... care hubs and community clinics across the state of CT, all connected by technology and common standards for quality. We employ several hundred medical, dental, and behavioral health providers who are engaged in practice, teaching, and research. Our Weitzman… more
- Highmark Health (Hartford, CT)
- …and privileging requirements of the Department of Health, Joint Commission, NCQA , URAC and other governmental requirements, and performs in accordance with ... these standards. Generates and maintains accurate documentation that may be reviewed and judged for acceptability by state and federal licensing agencies. Handles customer questions and complaints. **ESSENTIAL RESPONSIBILITIES** + Reviews medical staff and… more
- Moses/Weitzman Health System (New London, CT)
- …center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA , respectively. We deliver more than 500,000 patient visits per year from primary ... care hubs and community clinics across the state of CT, all connected by technology and common standards for quality. We employ several hundred medical, dental, and behavioral health providers who are engaged in practice, teaching, and research. Our Weitzman… more
- Evolent (Hartford, CT)
- …Experience with value-based care, utilization management, or regulatory reporting (eg, HEDIS, NCQA , Milliman). **To comply with HIPAA security standards (45 CFR sec. ... 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available… more
- Moses/Weitzman Health System (CT)
- …center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA , respectively. We deliver more than 500,000 patient visits per year from primary ... care hubs and community clinics across the state of CT, all connected by technology and common standards for quality. We employ several hundred medical, dental, and behavioral health providers who are engaged in practice, teaching, and research. Our Weitzman… more
- CVS Health (Hartford, CT)
- …policy development, and corrective action planning. **Preferred Qualifications** + NCQA credentialing experience. + Familiarity with tools such as QuickBase, ... Excel, and provider data platforms. + Project management experience. + Strong analytical and data-driven decision-making skills. + Ability to influence and collaborate across all levels of the organization. **Education** + Bachelors degree preferred or a… more
- Evolent (Hartford, CT)
- …Review Accreditation Commission (URAC) and National Committee for Quality Assurance ( NCQA ) guidelines. + Provides clinical rationale for standard and expedited ... appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. + Participates in on-going training per inter-rater reliability process. + On a requested basis, may function as… more
- Moses/Weitzman Health System (Meriden, CT)
- …center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA , respectively. We deliver more than 600,000 patient visits per year from primary ... care hubs and community clinics across the state of CT, all connected by technology and common standards for quality. We employ several hundred medical, dental, and behavioral health providers who are engaged in practice, teaching, and research. Our Weitzman… more
- Evolent (Hartford, CT)
- …Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ( NCQA ) guidelines. . Aids and acts as a resource to Initial Clinical ... Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more