- 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 (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
- Humana (Austin, TX)
- …within Humana. **Role Responsibilities:** + Serves as subject matter expert on NCQA Health Plan Accreditation Member Experience (ME) and Medicaid Module (MED) ... areas to prepare documentation and files for presentation to NCQA . + Advises operational leaders and frontline associates in...or BSN degree. + 3+ years of experience in NCQA Health Plan Accreditation and/or Medicaid Module. + Exceptional… more
- 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 (Fort Worth, TX)
- …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
- Kelsey-Seybold Clinic (The Woodlands, 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 (Humble, 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 (Webster, 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 (Sugar Land, 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
- Molina Healthcare (Austin, TX)
- …calls from members, providers, and pharmacies to meet departmental, State regulations, NCQA guidelines, and CMS standards. + Provides coordination and processing of ... requests and/or appeals. + Explains Point of Sale claims adjudication, state, NCQA , and CMS policy/guidelines, and any other necessary information to providers,… more