• CVO Credentialing Coordinator Sr.

    CommonSpirit Health Mountain Region (Centennial, CO)
    …to established legal, State and Federal agencies, State licensing board, TJC, and NCQA standards. Coordinates, tracks, and monitors flow of information to ensure the ... timely processing and notification of applicants in accordance with the guidelines established. + Conduct quality reviews of new associates to ensure accuracy in file processing and data entry, and provide ongoing monitoring and mentorship for established CVO… more
    CommonSpirit Health Mountain Region (09/06/25)
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  • Credentialing Specialist - Full Time (Corporate)

    Henry Ford Health System (Detroit, MI)
    …in compliance with the accrediting and regulatory agencies (ie The Joint Commission, NCQA , URAC, HFAP) in regards to credentialing while developing and maintaining a ... working knowledge of the statutes and laws. + Improves professional growth, knowledge of job to maintain efficiency and effectiveness of the CCS by participating in professional organizations, attending seminars and reading journals and publications addressing… more
    Henry Ford Health System (09/06/25)
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  • Business Information Analyst Senior

    Elevance Health (Charleston, WV)
    …Familiarity with quality and outcomes measures such as HEDIS, STAR ratings, NCQA , CMS quality metrics, or state-specific reporting requirements. + Ability to ... manipulate large sets of data is strongly preferred. + Strong analytical, organizational and problem solving skills are strongly preferred. + Experience with data visualization tools (Tableau, Power BI, Qlik) strongly preferred. If this job is assigned to any… more
    Elevance Health (09/06/25)
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  • Care Management Associate

    CVS Health (Arlington, TX)
    …processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, ... while adhering to company policy and procedures. * Demonstrated ability to handle multiple assignments competently, accurately, and efficiently. Customer service experience, Knowledge of Medical Terminology **Education** * High School Diploma or GED… more
    CVS Health (09/06/25)
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  • Credentialing Specialist Managed Care

    AdventHealth (Maitland, FL)
    …with AHS. Responsible for ensuring compliance with regulatory bodies (Joint Commission, NCQA , CMS, federal and state), as well as medical staff bylaws, rules ... and regulations, policies and procedures, and delegated contracts. + Performs miscellaneous job-related duties as assigned. **The expertise and experiences you'll need to succeed:** High School Grad or Equiv Attentive to detail and accuracy; strong… more
    AdventHealth (09/06/25)
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  • Medical Staff Credentialing Specialist

    Community Health Systems (Huntsville, AL)
    …requirements. + Ensures adherence to standards set by The Joint Commission, CMS, NCQA , and other regulatory or accrediting bodies. + Prepares credentialing files and ... documentation for review by medical staff committees and leadership. + Assists with the coordination and documentation of medical staff meetings and committee reviews. + Communicates with providers, department heads, regulatory agencies, and other healthcare… more
    Community Health Systems (09/06/25)
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  • Nurse Practitioner, Physician Assistant, Clinical…

    Cleveland Clinic (Cleveland, OH)
    …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
    Cleveland Clinic (09/06/25)
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  • Care Management Associate

    CVS Health (Frankfort, KY)
    …processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, ... while adhering to company policy and procedures. Background/Experience Desired: + Experience or detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs,… more
    CVS Health (09/06/25)
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  • Credentialing Specialist

    MVP Health Care (Schenectady, NY)
    …applications of providers and organizational facilities in accordance with MVP Policies, NCQA standards, CMS, NYS Department of Health and other regulatory agencies. ... + Processes Credentialing and Recredentialing Applications for practitioners and organizational providers including preparing files for the MVP Credentials Committee. + Conducts primary source verifications from various sources (hospitals, residency programs,… more
    MVP Health Care (09/06/25)
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  • Professional, Quality Analyst

    MVP Health Care (Schenectady, NY)
    …in healthcare data- claims, coding, HIE's etc. Experience with quality metrics, ( NCQA HEDIS and NYS QARR) standards strongly preferred + Strong analytical skills, ... with the ability to turn data into actionable insights + Proficiency in SQL, data visualization tools (eg Tableau, PowerBI) + Data Manipulation tools (eg Alteryx, R, Python) beneficial + Excellent verbal and written communication skills, with the ability to… more
    MVP Health Care (09/06/25)
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