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Capable of operating business units in conformance with good quality and business practices as may be outlined by agencies such as The Joint Commission, NCQA, MGMA, etc. The incumbent stays abreast of current advances in medicine by reviewing recent publications, attending in-services and educational meetings, and attending continuing medical education programs in the appropriate field.
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Remaining compliant with and knowledgeable of rules and regulations set forth by the Health Information Portability and Accountability Act (HIPAA), Joint Commission standards, the HCQIA, the National Committee for Quality Assurance (NCQA), the Centers for Medicare and Medicaid Services, as well as state regulations— and relays this information to the necessary parties to ensure ongoing compliance organization-wide.
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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.
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We are accredited by the Joint Commission and are the first Community Health Center in Washington State to be recognized as a Patient-Centered Medical Home by the National Center for Quality Assurance (NCQA.
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CHC is designated as a federally qualified health center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA, respectively. CHC is designated as a federally qualified health center and a patient-centered medical home by HRSA, the Joint Commission, and NCQA, respectively.
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Knowledge of Joint Commission, CMS and other laws/regulations highly preferred. Additional responsibility is to monitor reappointments to assure none go over 24 months, per TJC standards and/or 36 months, per NCQA standards.
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Maintains and assures implementation of all Joint Commission/Patient Centered Medical Home, and NCQA certification requirements. SUPERVISES: Directly supervises Director of RW Clinical Services, Staff Physicians, Mid-Level Providers, Psychiatrist, and Director of Nursing, and Behavioral Health Director.
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One of the following is preferredo Clinical certification in area specialtyo CPHRM - Certified Healthcare Risk Managemento CJCP - Certified Joint Commission Professionalo CPHQ - Certified Professional Healthcare Quality.
$41.75 - $62.62 an hourFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Ensures treatment and consultations consistent with NCQA (National Committee for Quality Assurance), TJC (The Joint Commission on Accreditation of Healthcare Organizations), and federal and state regulatory standards.
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Regulatory ComplianceMaintain a working knowledge of applicable National, State, and local laws and regulations, as well as, Joint Commission, NCQA and other regulatory requirements that relate to the medical staff.
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Job Description:Under direct supervision, works as part of a team to maintain providers privileges and credentials in accordance with criteria set forth by the National Committee on Quality Assurance (NCQA) and Joint Commission (JC); provides related administrative and clerical support; other duties as assigned.
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ADMINISTRATIVECompletes all documentation required by state regulations, Joint Commission standards, and CHC Behavioral Health department by laws in a timely manner, included by not limited to intake, prior authorization request, progress notes, treatment plan documentation, and discharge.
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Knowledge and experience with PCMH standards(NCQA/AAAHC/Joint Commission/BCBS). At Covenant Community Care, we are a faith based non-profit, Federally Qualified Health Center serving the communities of Detroit in our clinics that offer integrated medical, dental and behavioral healthcare.
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Knowledge of early childhood development, parent education, parent-child relationships, and individual, family, and community-level risk factors (e.g., poverty, homelessness, maternal depression, domestic violence, substance abuse, teen parenthood.
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Maintains all Medical Staff material as a form readily retrievable as needed for regulatory bodies such as The Joint Commission, CMS, the New York State Department of Health, NCQA and IPRO.
$62,657 - $105,000 a yearFull-timeExpandApply NowActive JobUpdated 2 days ago
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