- Integra Partners (Troy, MI)
- The Quality & Accreditation Specialist is responsible for coordinating and maintaining accreditation activities for the Utilization Management (UM) and ... Credentialing departments. This includes supporting NCQA accreditation , implementing quality monitoring initiatives, conducting internal reviews, and… more
- Molina Healthcare (MI)
- …key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ... **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or more of these quality improvement functions: … more
- Henry Ford Health System (Jackson, MI)
- …understanding of medical staff credentialing and regulatory requirements. Experience with accreditation standards (eg, Joint Commission, NCQA , URAC, HFAP). ... Credentialing Specialist - Medical Staff Affairs - Days Location:...medical staff meetings, and ensuring compliance with regulatory and accreditation standards. The coordinator serves as a key resource… more
- Trinity Health (Livonia, MI)
- …Medicare and Medicaid (CMS), The Joint Commission (TJC), and National Commission for Quality Assurance ( NCQA ) rules and regulations that govern credentialing and ... with applicable rules and regulations. Coordinates projects to improve the quality and efficiency of the credentialing and privileging process. **ESSENTIAL FUNCTIONS… more
- University of Michigan (Ann Arbor, MI)
- …Medicare and Medicaid (CMS), The Joint Commission (TJC), the National Committee for Quality Assurance ( NCQA ), Accreditation Commission for Health Care ... accreditation requirements. Through delegated credentialing contracts, the credentialing specialist completes this work on behalf of each contracted plan,… more
- Molina Healthcare (Grand Rapids, MI)
- …clean credentialing file approvals by Medical Directors, credentialing audits and accreditation survey's, oversight of credentialing work done by vendors, developing ... team, directs work, ensures turn-around time requirements are being met and monitors quality of work by conducting regular audits and tracking results. * Guides and… more
- Evolent (Lansing, MI)
- …Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ( NCQA ) guidelines. + Ensures documentation of all ... Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to...skills + Energetic and curious with a passion for quality and value in health care + Computer Proficiency… more
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