• Senior Accreditation Utilization Management…

    Humana (Austin, TX)
    …Humana. **Role Responsibilities:** + Serves as subject matter expert on NCQA Health Plan Accreditation UM requirements, advising stakeholders on compliance, and ... facilitating NCQA UM survey activities. + Works closely with operational...areas to prepare documentation and files for presentation to NCQA . + Advises operational leaders and frontline associates in… more
    Humana (09/03/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Austin, TX)
    …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 (08/28/25)
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  • National Manager, Delegation Oversight

    Molina Healthcare (TX)
    …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 (07/09/25)
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  • Credential Delegation Analyst

    Highmark Health (Austin, TX)
    …coordinates and maintains delegated credentialing program in accordance with GHP, NCQA , and all regulatory agency standards. This includes delegation program, ... oversight of credentialing delegates to ensure that the delegated entities meet all NCQA , DPW, and DOH, policies and procedures related to GHP's delegated program. +… more
    Highmark Health (09/05/25)
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  • Lead Abstractor, HEDIS/Quality Improvement (Remote…

    Molina Healthcare (Fort Worth, TX)
    …+ 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 (08/08/25)
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  • Physician - Internal Medicine Hospitalist

    Kelsey-Seybold Clinic (Porter, TX)
    …Kelsey-Seybold has been recognized by the National Committee for Quality Assurance ( NCQA ) as the nation's first accredited Accountable Care Organization and a Level ... area certified for excellence in diabetes and heart and stroke care by the NCQA . In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited… more
    Kelsey-Seybold Clinic (09/06/25)
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  • Physician - Internal Medicine Nocturnist

    Kelsey-Seybold Clinic (Porter, TX)
    …Kelsey-Seybold has been recognized by the National Committee for Quality Assurance ( NCQA ) as the nation's first accredited Accountable Care Organization and a Level ... area certified for excellence in diabetes and heart and stroke care by the NCQA . In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited… more
    Kelsey-Seybold Clinic (09/06/25)
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  • Physician - Cardiology (Electrophysiologist)

    Kelsey-Seybold Clinic (Houston, TX)
    …Kelsey-Seybold has been recognized by the National Committee for Quality Assurance ( NCQA ) as the nation's first accredited Accountable Care Organization and a Level ... area certified for excellence in diabetes and heart and stroke care by the NCQA . In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited… more
    Kelsey-Seybold Clinic (09/06/25)
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  • Physician - Cardiology (Imaging)

    Kelsey-Seybold Clinic (Houston, TX)
    …Kelsey-Seybold has been recognized by the National Committee for Quality Assurance ( NCQA ) as the nation's first accredited Accountable Care Organization and a Level ... area certified for excellence in diabetes and heart and stroke care by the NCQA . In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited… more
    Kelsey-Seybold Clinic (09/06/25)
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  • CM Delegation Liaison

    Molina Healthcare (TX)
    …health plan state provider agreement, National Committee for Quality Assurance ( NCQA ), Centers for Medicare and Medicaid Services (CMS), policies and procedures, ... * Assists in preparation of documents for utilization management, care management, state, CMS, NCQA and other regulatory audits as needed. * Local travel of up to… more
    Molina Healthcare (09/05/25)
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