• Integrated Health Advancement Program

    Blue KC (MO)
    …discount program ** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome ... performance measurement, including design of incentive programs, HEDIS/STAR improvement efforts, and NCQA accreditation or Health Equity Accreditation +… more
    Blue KC (12/04/25)
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  • Business Analytics Senior Manager (Clinical…

    The Cigna Group (Bloomfield, CT)
    … Support** + Define and consult on measurement strategies and tools to support NCQA accreditation and state regulatory requirements + Ensure data integrity and ... **Job Profile Summary:** The Business Analytics Sr. Manager oversees a team of analytics professionals focused on clinical quality measurement and insights. Works in… more
    The Cigna Group (11/22/25)
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  • Case Manager , RN (Medicare - Multiple…

    Excellus BlueCross BlueShield (Rochester, NY)
    …Federal Employee Program (FEP) and National Committee for Quality Assurance ( NCQA ) accreditation standards, as appropriate to the member's case assignment. ... Maintains knowledge of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the… more
    Excellus BlueCross BlueShield (12/08/25)
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  • Case Manager - Registered Dietician

    CDPHP (Latham, NY)
    …Federal Employee Program (FEP) and National Committee for Quality Assurance ( NCQA ) accreditation standards, as appropriate to the member's case assignment. ... Maintains knowledge of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the… more
    CDPHP (11/25/25)
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  • Manager , Case Management (Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …CMS, NCQA and BlueCross BlueShield Association (BCBSA) for the Federal Employee Program (FEP). The Manager serves as a resource to management, internal ... and all regulatory and accrediting standards including NYS DOH, CMS, FEP and NCQA formal accreditation activities. Keeps abreast of changes and responsible for… more
    Excellus BlueCross BlueShield (12/16/25)
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  • Clinical Quality Program Manager

    Elevance Health (Los Angeles, CA)
    …employment, unless an accommodation is granted as required by law_ The **Clinical Quality Program Manager ** is responsible for serving as a liaison with and ... Maintains effective documentation of research programs to meet regulatory and Accreditation Standards. + Provides oversight to assure accurate and complete… more
    Elevance Health (12/03/25)
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  • Nurse Case Manager - Senior Care Options

    Fallon Health (New Bedford, MA)
    …provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for the Elderly)- in the region. ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...for MassHealth programs such as the personal care attendant program , adult foster care, group adult foster care, and… more
    Fallon Health (12/12/25)
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  • Clinical Care Manager - Pediatric

    WellSense (NH)
    …manner and in keeping with contractual requirements, internal policy and NCQA accreditation standards. Facilitates multidisciplinary consultation on members' ... our members, no matter their circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members throughout the… more
    WellSense (12/06/25)
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  • Medicare Part D Formulary Manager

    Excellus BlueCross BlueShield (Rochester, NY)
    …you, we encourage you to apply! Job Description: This pharmacist clinician is a program manager , who is responsible for all Medicare Part D formulary creation ... while ensuring the longevity of the Plan's Part D program . Essential Accountabilities: + Develops and maintains the Part...and state regulatory agencies (CMS, DOH, DFS, etc.) and/or accreditation agencies ( NCQA , BCBSA) is preferred, but… more
    Excellus BlueCross BlueShield (12/09/25)
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  • Quality Improvement Manager

    Chapa-De (Auburn, CA)
    …empowers teams and improves care at every level. The Quality Improvement Manager provides oversight and leadership on agency-wide quality and performance improvement ... Responsibilities: + Implements the Quality and Performance Improvement (QAPI) Program in alignment with the organization's mission, strategic goals, federal/state… more
    Chapa-De (11/16/25)
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