- 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
- 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
- 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
- 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
- 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 (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 (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 (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
- 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
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