- Molina Healthcare (Savannah, GA)
- …management. **Job Duties** ** Program Oversight & Project Management** + Directs accreditation work plans and timelines to meet NCQA and contractual ... department or cross-functional teams of subject matter experts, delivering on NCQA accreditation requirements. Plans and directs schedules, reporting, process… more
- CareFirst (Baltimore, MD)
- …include oversight of Health Plan and Health Equity accreditation . Enhance program performance in preparation for NCQA submission. Guides stakeholders through ... with internal and external stakeholders to launch, maintain, and enhance NCQA accreditation strategies and interventions. Provides direction and motivation… more
- Columbia Memorial Hospital (Astoria, OR)
- …Professional in Healthcare Quality (CPHQ). Preferred: Credential(s) from the Healthcare Accreditation Certification Program (s) (HACP). Preferred: Three (3) years ... ELIGIBLE FOR CMH EMPLOYEE REFERRAL BONUS: NON-PRIORITY RECRUITMENT The Accreditation , Regulatory, and Licensing Nurse Specialist ensures compliance with licensing, … more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …transform healthcare? Bring your true colors to blue. The Role:The Medical Clinical Program Manager will focus on utilization management compliance and audit ... risks to closure, and collaboratively develop mitigation strategies. Other NCQA accreditation work includes delegation oversight and...part of HMM Quality and Compliance team, the Clinical Program Manager works through the influence as… more
- OhioHealth (Columbus, OH)
- …and in our communities. **Job Description Summary:** The Central Verifications Office Credentialing Program Manager (CVO PM) reports to the Director of CVO & ... the CVO to support TJC accreditation for the OhioHealth hospitals and NCQA accreditation to support the CIN and OhioHealthy Medical Plan. The CVO PM is… more
- Highmark Health (Camp Hill, PA)
- …(FEP) Quality Program , (b) the National Committee for Quality Assurance ( NCQA ), (c) Joint Commission accreditation compliance, (d) quality measures required ... Quality Program , (b) the National Committee for Quality Assurance ( NCQA ) compliance, (c) Joint Commission accreditation compliance, (d) quality measures… more
- Excellus BlueCross BlueShield (Dewitt, 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
- CVS Health (Lansing, MI)
- …/ Medicaid experience -Experience with HEDIS Metrics, CAHPS Member Satisfaction Surveys, NCQA Accreditation , Compliance Audits and/or MI State Reporting / ... Summary** Supportive of State of Michigan Quality Contract deliverables, QAPI Program and regulatory standards. Processes and evaluates complex data and information… more
- Whitney Young Health Center (Albany, NY)
- …regulation (FQHC), ie DHHS HRSA, CMS guidelines, and NYSDOH (article 28), and all accreditation standards (eg Joint Commission and NCQA -PCMH). + Adheres to the ... Registered Nurse (RN) Care Manager - Women's Health/Pediatrics Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description Be a… more
- Fallon Health (Worcester, MA)
- …provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for the Elderly)- in the region. ... follow us on Facebook, Twitter and LinkedIn. **Brief Summary of Purpose:** The Manager , Prior Authorization RN manages all staffing and activities related to prior… more
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