- UpvoteDownvoteShare Job
- Suggest Revision
Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal). Promotes enrollment in care management programs and/or health and disease management programs.
ExpandApply NowActive JobUpdated 29 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Wise & Healthy Aging has received numerous designations of excellence from Guide Star, GREATNONPROFITS, and NCQA Case Management for Long-Term Services & Support, and it is nationally certified as a Great Place to Work.
Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Role: Case Management Coordinator-CW. Responsible for after-action items as outcome of Quarterly State Audit Reviews, Annual MERCER Review and NCQA Review. Role: Case Management Coordinator-CW.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Behavioral Health RN provides structure and maintains a safe therapeutic recovery oriented environment; uses the therapeutic relationship and counseling interventions to assist health care consumers in an inpatient setting which offers psychotherapy, group therapy, occupational and recreational therapy, mental health education, psychiatric case management, medication management, nursing care, and medical management.
$65,000 - $122,000 a yearFull-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Previous experience to have a strong understanding of Utilization Management/Case Management practices including, but not limited to, placement (with level of care) criteria (MCG, InterQual), concurrent review, and discharge planning.
$88,854 - $142,166 a yearFull-timeExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards. As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team.
RemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Manage members that have been assessed by the LTSS, Event Driven Care, or Complex Case Management Case Managers/Health Coordinators to implement member’s health action plans (HAP)/care plans to ensure timely services are in place.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Accrediting bodies include, but not limited to, the Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC), and the Joint Commission (TJC.
Full-timeExpandUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of regulatory and accreditation standards (URAC NCQA) and complex case management (CMSA). This position will involve telephonic case management and direct patient contact through follow up at clinic appointments and/or home visits as needed.
ExpandUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment.
ExpandUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
PCHC also provides integrated behavioral health, nurse case management, dental, optometry, podiatry, dermatology, rheumatology, nephrology and asthma/allergy services. We have 9 neighborhood-based clinics (NCQA Level 3 patient-centered medical homes) – all located within minutes of one another in the city of Providence – and we serve more than 85,000 patients.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics is required. Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred.
$79,809.6 - $101,774.4 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Experience with NCQA, HEDIS, Medicaid, Medicare, quality improvement, utilization management, and risk adjustment. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
The Manager collaborates with the Regional Director of Case Management, medical directors, PCPs, clinic and corporate medical management leadership on care coordination activities.
Full-timeExpandApply NowActive JobUpdated 11 days ago
ncqa case management jobs
FEATURED BLOG POSTS
Land a Production Supervisor Job With These 5 Resume Tips
Have you been working as a team lead on a factory floor or in a manufacturing plant for several years? Do you consider yourself a leader who excels at managing and coaching others? Can you monitor and optimize production processes? Do you recognize the importance of employee safety and compliance? If you’re answering yes to all of these questions, then you’re definitely in the right place.
Assistant Manager Resume Guide
It can be very challenging for many individuals to find a job in the current economy. As a result, the unemployment rate is only starting to decrease after being at its highest since the Great Depression. One of many reasons this is occurring is because this pandemic has encouraged people to quit their jobs to search for better working conditions, become entrepreneurs, or change careers.
How to Build a Supervisor Resume
Writing a great supervisor resume doesn't have to be rocket science. All you need to do is figure out what the company requires and how best to appeal to their needs. In other words, see the resume as your “key” into any organization of choice.
The Ultimate Guide to Writing a Stellar Sales Manager Resume
Have you been working in sales for several years now and feel ready to move up the career ladder? Do you enjoy leading sales teams and developing strategies to drive company sales? Would you describe yourself as a strong communicator, negotiator, and closer? If so, then there’s a good chance that a sales manager position might be the ideal fit for you.
How to Write a Chief Operating Officer Resume + Sample
Are you looking to become the Chief Operating Officer in your company of choice? Do you want to create a compelling COO resume that will earn you the job? This article is for you.
Get Ready, The Beginning of the Year is the Best Time to Job Search
Frankly, if you need a job, the best time to apply for one is right now. But, regardless of timing, the competition is fierce and job seekers should do everything they can to score an advantage. Understanding when companies hire, the typical hiring season trends, and the right time of year to apply for jobs will give you the best chance at success.
The Ins and Outs of Building a Resume From a Bar Manager Job Description
Many people turn their noses up at bartending jobs, as they do for most jobs in the food service industry. Little do they know, bartenders possess a lot of unique skills. Even though these jobs can require little to no education, bartenders must go through extensive training or schooling. Additionally, the demand for these jobs is extremely high, and the career growth opportunities often bring bartenders into management positions after years of experience.