- Molina Healthcare (FL)
- …adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA -compliant ... and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. + Reviews quality referred issues, focused… more
- Molina Healthcare (Orlando, FL)
- …and state delegated activities, ensuring compliance with State, Federal, NCQA and Molina delegation standards and requirements. Provides delegation oversight ... delegation audit assessment tools as necessary to comply with state, federal, NCQA , and any other applicable requirements. + Assists with chairing monthly meetings… more
- Molina Healthcare (St. Petersburg, FL)
- …+ Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits by reviewing clinical documentation. + Provides ... review and abstraction + Intermediate knowledge of HEDIS and NCQA **PR** **E** **FE** **R** **RED E** **X** **PE**...managed care experience. + Advanced knowledge of HEDIS and NCQA . **PR** **E** **FE** **R** **RED L** **I** **C**… more
- Molina Healthcare (Miami, FL)
- …measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ... provides the strategic direction and implementation of corporate and/or Molina plan NCQA accreditation surveys and federal and state QI Compliance activities. +… more
- Molina Healthcare (Miami, FL)
- …for review. + Assures that activities and processes are compliant with NCQA guidelines and Molina policies and procedures and promotes best practice measures ... Quality Management and Health Education programs including, but not limited to, NCQA Accreditation, HEDIS, and Disease Management programs company wide. + Attends… more
- Centene Corporation (Spring Hill, FL)
- …practice sites in regards to the National Committee for Quality Assurance ( NCQA ) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with NCQA requirements. + Collects, summarizes and trends provider performance data to… more
- Intermountain Health (Tallahassee, FL)
- …per CMS Condition of Participation (COP) or National Clinical Quality Association ( NCQA ) standards. Ensures a plan of care is developed and maintained for ... members receiving care management services consistent with COP/ NCQA and department standards. + Coordinates and facilitates communication among the member/caregivers… more
- Highmark Health (Tallahassee, FL)
- …telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA , URAC, CMS, DOH, and DOL regulations at all times. In addition to ... and provider determination notifications all while adhering to required compliance standards ( NCQA , URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all… more
- Centene Corporation (Tallahassee, FL)
- …management of activities related to National Committee for Quality Assurance ( NCQA ) Accreditation and Healthcare Effectiveness Data and Information Set (HEDIS) ... experience including, quality and process improvement experience requiredExperience with NCQA accreditation preparation and auditing, including the analysis of HEDIS… more
- Cleveland Clinic (Weston, FL)
- …states Licensing Board. + Current DEA License or DEA designee as required by NCQA . + Basic Life Support (BLS) through the American Heart Association (AHA) required. ... + Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP); or Advanced Trauma Life Support (ATLS)… more