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Participates in Quality Management and Health Education programs including, but not limited to, NCQA Accreditation, HEDIS, and Disease Management programs company wide. Working knowledge of medical/pharmacy terminology, State and NCQA guidelinesRequired License, Certification, AssociationActive and unrestricted Pharmacist license in good standing.
Starting at $87,568.7 - $189,732.18 a year depends on education, experienceFull-timeRemoteExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Responsible for achieving quality goals related to Centers for Medicare and Medicaid Services (CMS) STARS rating measures for both the Health Plan and AHN, in collaboration with the VP Government Quality and AHN quality leadership.
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Responsible for leading all NCQA Health Equity Accreditation work for Humana's Medicaid markets. Demonstrated expertise in NCQA accreditation and related processes, especially Health Equity Accreditation or Multicultural Healthcare Distinction.
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Work with Senior leadership to support certification and accreditation processes with National Committee for Quality Assurance (NCQA)Serve as an expert in the administration and maintenance of credentialing and provider data management systems, including the Council for Affordable Quality Healthcare (CAQH), Credentialing System and proprietary claim systems.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Comply with all regulatory and quality agency standards including: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Services (DHS), and accreditation bodies’ standards such as the National Commission of Quality Assurance (NCQA) as it relates to care management activities.
ExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Awareness of NCQA requirements, CMS guidelines, Medicaid/Medicare contracts and benefit systems. 2+ years of clinical experience, primary care, home-based medical care, geriatrics or palliative care or emergency/urgent care.
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Adheres to all Corporate and Departmental policies and ensures all regulatory requirements such as DOH, CMS, Medicaid, and accreditation requirements such as NCQA, URAC and HEDIS functionalities are met or exceeded.
$40 an hourExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Leads a small team responsible for NCQA Health Equity Accreditation. They will work closely with cross-functional teams to ensure compliance with NCQA standards, manage team workload and work assignments, and play a key role in NCQA survey administration tasks.
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Demonstrated knowledge of case management, discharge planning, transition of care, transfer coordination; Medicare, Medicaid, Title 22, NCQA, JCAHO, URAC, and other federal/state/local regulations.
$148,800 - $192,500 a yearFull-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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Working knowledge of healthcare quality performance and measurement sets including CMS quality withhold, Managed Care Accountability Set, NCQA Quality Improvement Standards and HEDIS. Specifically, develops continuous and targeted activities to improve performance related to Centers for Medicare & Medicaid Services (CMS) Star Ratings, HEDIS, CAHPS, HOS, P4P and other identified performance measures.
Full-timeExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Collaborates with cross-functional teams to ensure compliance with NCQA standards. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
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2+ years clinical experience, primary care, home-based medical care, geriatrics or palliative care or emergency/urgent care. Comfortable with basic procedures of nursing care, including IV placement, blood draws, injections, foley catheters, nasal packing, wound care, etc.
ExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Become a part of our caring community and help us put health first. Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor.
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Responsible for working with the regional head of quality management to direct the clinical quality initiatives, including HEDIS and CAHPS quality improvement, NCQA accreditation and compliance with regulatory agencies and other objectives.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Helpful but not required: an awareness of UM standards, NCQA requirements, CMS guidelines, and Medicaid/Medicare contracts and benefit systems. Home-Based Primary Care Physician for Seniors.
$220,000 - $320,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago
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