- Molina Healthcare (Savannah, GA)
- …or cross-functional teams of subject matter experts, delivering on NCQA accreditation requirements. Plans and directs schedules, reporting, process improvement, ... + Directs accreditation work plans and timelines to meet NCQA and contractual deadlines. + Manages cross-functional teams and...teams and external vendors to ensure deliverables align with NCQA standards. + Oversees submissions to NCQA … more
- CareFirst (Baltimore, MD)
- …Health Equity accreditation. Enhance program performance in preparation for NCQA submission. Guides stakeholders through key decisions, communicates and coordinates ... regulatory requirements. Supports the organization's understanding and compliance with current NCQA standards. **_We are looking for an experienced professional in… more
- The Boeing Company (Mesa, AZ)
- …Space & Security** (BDS) is seeking a **Numerical Control Quality Engineer - NCQA (Mid-Level or Senior)** to support the **Air Dominance Proprietary** team in ... **Mesa, Arizona** . **This position may be located on either 1st or 2nd shift and follows a 9/80 working schedule.** **This is at the hiring team's discretion and could potentially change in the future depending on the business needs.** This position will be… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and Medical Management's (HMM) and delegate's compliance with the applicable NCQA utilization management standards and state and federal regulations. This position ... risks to closure, and collaboratively develop mitigation strategies. Other NCQA accreditation work includes delegation oversight and preparing documentation for… more
- Centene Corporation (Oklahoma City, OK)
- …in accordance with policies, guidelines, and National Committee for Quality Assurance ( NCQA ) standards. + Prepares case reviews for Medical Directors by researching ... processing, and response to appeal in accordance with State, Federal and NCQA standards + Communicates with members, providers, facilities, and other departments… more
- Humana (Louisville, KY)
- …draft detailed SAFe stories with success criteria to modify data feeds as NCQA rulesets change. **** **Data & Technical Leadership and influence:** + Work closely ... logic. + Stay up to date with evolving CMS, NCQA , and HEDIS requirements. + Ensure the data processing...**HEDIS measurement** + Familiarity with **CMS Stars programs** , NCQA standards, and quality performance metrics. + Experience working… more
- Commonwealth Care Alliance (Boston, MA)
- …operations and compliance of the Appeals and Grievances department through many NCQA and other related quality program activities including: monthly case quality ... and training and areas on noncompliance. In addition to NCQA program support, this role will also support compliance...Peer calls between requesting MDs and CCA MDs, per NCQA requirements. + Coordinate BOH hearings with external State… more
- Molina Healthcare (Layton, UT)
- …adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA -compliant ... and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. + Reviews quality referred issues, focused… more
- Martin's Point Health Care (Portland, ME)
- …bodies. + Maintains detailed project documentation in accordance with the NCQA HEDIS technical specifications, and HEDIS compliance audit standards, policies, and ... data collection, medical record review, and data extraction. + NCQA and HEDIS Experience. + Project management experience in...procedures as outlined by a governing body such as NCQA , TRICARE, or CMS. Required License(s) and/or Certification(s): +… more
- University of Rochester (Albany, NY)
- …and/or other sources as required based on Joint Commission and NCQA standards, hospital requirements, and credentialing policies. Ensures the accurate collection ... Medicaid and Medicare Services (CMS), National Committee for Quality Assurance ( NCQA ), State Department of Health, Occupational Health and Safety Association (OSHA),… more
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