- UpvoteDownvoteShare Job
- Suggest Revision
Engages and collaborates with HPSJ staff, subcontractors, downstream subcontractors, network providers, community-based organizations, local health departments, behavioral health, social services, child welfare systems, members, NCQA and DHCS regulatory officials and other stakeholders in health equity efforts and initiatives.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
This position will manage and direct projects in one or more (or related) high-priority NCQA content areas: behavioral health, health equity, geriatrics, overuse, and patient experience. They are responsible for balancing scientific rigor and being able to practically apply the evidence base in areas of strategic importance to NCQA, especially in the creation, expansion, maintenance of programs, measures, and evaluation products.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Creates detailed Quality Improvement Activity reports required for NCQA accreditation, evaluates outcomes, works with Quality Management Specialists to determine opportunities for improvement, and helps implement actions toward improvement.
ExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Advises and educates Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements. Conducts telephonic outreach and health coaching to members to support quality improvement, regulatory and contractual requirements.
$21 - $26 an hourFull-timeRemoteExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of HEDIS reporting and NCQA HEDIS Data Specifications. Supports data collection (including medical records), qualitative and quantitative analysis and transformation into information that can be reported to committees and work groups to identify opportunities for improvement.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Provide support for Appeals & Grievances process including clinical review of appeals when needed, documentation via the case management tool, and case presentation and follow-up via the Utilization Management Committee (UMC), as well as PBM PA team oversight and communication/retrain, and identification and operationalization of PA criteria and process improvement opportunities.
TemporaryExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Ensures compliance requirements are met for all regulatory bodies including CMS, NCQA, HEDIS, and Delmarva, as well as internal and external auditors. Operations management, change management, process improvement, and health care-related customer service methods.
ExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Continuous collaboration with CenCal Health’s internal and external stakeholders, to support and maintain compliance with National Committee for Quality Assurance (NCQA) Accreditation Standards for Population Health Management, Quality, and Health Equity as appropriate.
TemporaryExpandApply NowActive JobUpdated 23 days ago - UpvoteDownvoteShare Job
- Suggest Revision
California Medi-Cal and Medicare, NCQA and CMS standards, Quality Improvement studies, and HEDIS reporting. Provides executive management and leadership of the Alliance Health Services Division, which includes the Quality Improvement and Population Health, Pharmacy, Utilization Management and Complex Case Management, and Community Care Coordination Departments.
ExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
General working knowledge of utilization management, performance improvement standards and procedures and NCQA Standards. Licensed Registered Nurse (RN) or Licensed Practical Nurse (LPN), License to practice nursing in the State of Florida.
Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
Works closely and in collaboration with leadership throughout organization, including practice transformation, clinical integration, finance, payer relations, performance improvement, care management, patient experience, marketing and communications, internal and external partners to set the strategic direction for program development, performance improvement and resource deployment.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.
RemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Min. 3 years’ experience in healthcare with minimum 2 years’ experience in health plan quality improvement, managed care or equivalent experience. Evaluates project/program activities and results to identify opportunities for improvement.
$44,936.59 - $97,362.61 a yearRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Understand the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards and HIPAA. You will be responsible for working with our network providers in improving quality of care through quality improvement activities that will encompass HEDIS, CMS Star Rating, and health plan quality performance reporting.
$30 - $35 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
- Suggest Revision
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.
$42.31 - $83.27 an hourExpandApply NowActive JobUpdated 8 days ago
ncqa improvement jobs
FEATURED BLOG POSTS
Why Do Recruiters Ghost and What Can You Do About It?
Once you’ve finally mustered up the courage to find another job, leaning into the job hunt can feel scary and overwhelming. So, it does nothing to help your confidence when your outbox is full of unanswered follow-ups and interview requests. You thought that ghosting only happens on dating apps—so why do recruiters ghost, too? Recruiter ghosting is not an effective recruiting strategy, but sometimes it’s inevitable. How can you overcome such an unfortunate new career trend? Read on.
Internal Hiring Best Practices
Each companies hiring strategy is based on a set of rules that defines the ideal candidate. Many companies utilize internal and external hiring to ensure they have skilled, experienced workers. If you work in recruiting, maximizing your internal hiring strategies could be the key to retaining employees and simplifying your hiring process.
Why is it so Hard to Get a Job After College
For many, it was easy finding a job while in college. But after job hunting for weeks, you may wonder why it is so hard to get a job after college. After all, you’ve put a lot of time and effort into getting your degree. But don’t get discouraged. The University of Washington found that 53% of graduates are either unemployed or working a job that doesn’t require a degree. Other studies also show that landing your first job can take between 3 and 6 months. So, getting your first job takes time.
Why Leadership Is So Important in Your Career
There are plenty of baseball players worldwide, but only a select few will master the sport enough to play in the World Series. Similarly, you’ll meet hundreds of “managers” throughout your professional career. Still, only a few will cement themselves as true leaders in your mind. This is why leadership is important—the most influential leaders leave a mark. They inspire.
Making the Move to Salary Transparency
The salary transparency trend continues. Last year, Colorado passed its Equal Pay Transparency Rules, which required employers to include compensation in job postings, notify employees about promotional opportunities, and record job descriptions and wage records. Soon after, states like Washington, Nevada, Maryland, and Rhode Island followed suit.
Brand Reputation 101
People's initial perception of your organization is also known as your brand reputation. Your brand rep either encourages or discourages people from engaging with your company. This means the way people view your company will affect sales and even recruiting efforts.
Recruiting in a Tight Market
As a recruiter or employer, you know how much the economy affects your recruitment and retention efforts. You aren't just in competition with companies in your industry, but you are also fighting against inflation, recession, unemployment rates, and so much more.