- CVS Health (Olympia, WA)
- …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
- Premera Blue Cross (Mountlake Terrace, WA)
- …algorithms. + Recommend appropriate interventions to meet accreditation requirements ( NCQA , HEDIS, etc.). + Support the Specialty Pharmacy management program ... by recommending solutions to improve specialty drug therapy management for high-cost and complex drugs. + Assist in developing and maintaining provider and member communication materials that support clinical pharmacy programs. + Support and serve pharmacy… more
- Evolent (Olympia, WA)
- …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
- Evolent (Olympia, WA)
- …providing optimum customer service through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all ... communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by adhering to policies and procedures. + Participates in on-going training programs to ensure quality performance in… more
- Evolent (Olympia, WA)
- …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
- Evolent (Olympia, WA)
- …providing optimum customer service through professional/accurate communication and maintaining NCQA and health plans required timeframes. + Documents all ... communication with medical office staff and/or treating provider. + Practices and maintains the principles of utilization management by adhering to policies and procedures. + Participates in on-going training programs to ensure quality performance in… more
- Evolent (Olympia, WA)
- …Review Accreditation Commission (URAC) and National Committee for Quality Assurance ( NCQA ) guidelines. + 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 in research activities/questions related to the Utilization… more
- Sea Mar Community Health Centers (Lynnwood, WA)
- …hire date and is required to maintain current BLS CPR throughout employment. + NCQA (National Committee for Quality Assurance) Certification is a plus. + Valid WA ... State Driver's License and proof of liability insurance. What We Offer: Sea Mar offers talented and motivated people the opportunity to work in a dynamic and growing community health organization. Working at Sea Mar Community Health Centers is more than just a… more
- Molina Healthcare (WA)
- …and processes are compliant with CMS and National Committee of Quality Assurance ( NCQA ) guidelines and Molina policies and procedures. + Participates in the daily ... workload of the department, performing Technician and/or Representative duties as needed. + Interviews with potential technician and service representative job applicants and provides hiring recommendations to Manager or Director. + Provides coaching for the… more
- Sea Mar Community Health Centers (Ocean Shores, WA)
- …by The Joint Commission and recognized by the National Committee of Quality Assurance ( NCQA ) as a Patient Centered Medical Home (PCMH) level III. The Nurse Manager ... works in conjunction with Health Center Administrator and Clinical Director in daily operations of the clinic. Nurse Manager oversees clinical and administrative supervision of all the nursing personnel in the clinic. Ideal candidates will be empathetic, calm,… more