- 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
- Molina Healthcare (NE)
- …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
- Humana (Lansing, MI)
- …Ensures best practice standards and the National Committee of Quality Assurance ( NCQA ) Care Management criteria are used to assist with developing the documentation ... state and federal regulations, state Contract requirements, Humana policies and NCQA standards. **Use your skills to make an impact** **Required Qualifications**… 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
- Blue KC (MO)
- …medical leadership and advice for conformance with standards and guidelines for NCQA , URAC, state and federal regulators, and other accrediting bodies. + Acts ... face of change, and the courage to act with integrity. + Experience with NCQA and URAC accreditation preparation and review. + Experience managing others in a… more
- Intermountain Health (Murray, UT)
- …per CMS Condition of Participation (COP) or National Clinical Quality Association ( NCQA ) standards. Ensures a plan of care is developed and maintained for ... members receiving care management services consistent with COP/ NCQA and department standards. + Coordinates and facilitates communication among the member/caregivers… more
- UPMC (Pittsburgh, PA)
- …functions related to quality management and improvement, in compliance with NCQA , HEDIS, URAC the Commonwealth of Pennsylvania Department of Health quality ... for performing targeted audits. + Responsible for assisting with preparation for NCQA , URAC and other site visits. + Responsible for appropriate correspondence… 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 (Sioux City, IA)
- …and documents delegation assessments as necessary to comply with state, federal, NCQA , and any other applicable requirements. + Prepares status reports from ... Prepares delegation oversight document evidence for state monitoring visits and NCQA accreditation surveys and participates on Molina's work team. **JOB… more
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