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BHMSG Offers: Attractive salary with productivity and quality bonuses Generous amount of paid time off Comprehensive array of health benefits Retirement savings plan Employer paid malpractice coverage Relocation assistance available J1 and H1b sponsorship Our Community: Conveniently located in the center region of Connecticut.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada and Texas.
$38.61 - $61.78 an hourExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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ED SWCM assesses patient per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards and ensures a plan of care is developed and maintained for patients receiving care management services consistent with COP/NCQA and department standards.
$30.34 - $51.52 an hourFull-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Provides leadership and oversight for primary care service delivery improvement initiatives and programs such as NCQA Patient Centered Medical Home. Oversees MNHC’s participation in health plan Pay for Performance programs.
$108,000 - $122,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred. 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.
$79,809.6 - $101,774.4 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Required ExperienceMin. 3 years’ experience in healthcare with minimum 2 years’ experience in health plan quality improvement, managed care or equivalent experience. Preferred License, Certification, AssociationActive, unrestricted Certified Professional in Health Quality (CPHQ)Active, unrestricted Nursing License (RN may be preferred for specific roles)Active, unrestricted Certified HEDIS Compliance Auditor (CHCA)To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Starting at $44,936.59 - $97,362.61 a year depends on education, experienceFull-timeRemoteExpandApply NowActive JobUpdated 20 days ago - UpvoteDownvoteShare Job
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Dedicated to improving the health and well- being of patients, this position collaborates with the PCP, HBMC interdisciplinary teammates and consultants, and as needed, the health plan Medical Director and other health professionals, to develop and carry out patients' goals of care in all phases of the patient journey.
$40,000Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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HEDIS Certified Measures® is a registered trademark of the National Committee for Quality Assurance (NCQA). HSAG's auditors are provided formal training in an assortment of healthcare-related topics, including health policy, clinical concepts, overview of analytic methods, data sources, and management techniques.
RemoteExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Utilizes clinical proficiency and claims knowledge/analysis to assess, plan, implement, health coach, coordinate, monitor, and evaluate medical necessity and/or care plan compliance, options, and services required to support members in managing their health, chronic illness, or acute illness.
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In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.
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Awareness of NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems. Implements HEDIS measure campaigns and other quality initiatives as directed by Corporate Health Services to ensure the highest standards of care and to promote the improvement of care management and delivery.
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Full time FLEX schedule Behavioral Health RN position offering 3(12) DAY shift with generous PTO, Retirement plan with company match and up to 30% shift differentials. Award winning, highly respected MAGNET healthcare system with over 100+ years of rich history and patient success having accreditations from some of the most distinguished health care organizations in the country including the American Heart Association, CMS and NCQA.
$65,000 - $122,000 a yearFull-timeExpandApply NowActive JobUpdated 18 days ago - UpvoteDownvoteShare Job
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The RN Care Manager develops person-centered care goals, identifies barriers to health and implements interventions to meet patient goals through development of an individualized care plan with emphasis on promoting patient self -management and family responsibility.
RemoteExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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The RN Care Manager utilizes clinical expertise and understanding of care management, CMS and NCQA regulatory requirements, quality measures of care, and provides safe and appropriate patient transitions across different levels of care.
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Support responding to external health plan audits of utilization management, claims, and credentialing operations, by completing audit questionnaires, submitting polices, and preparing operational records requested.
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