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1-15 of 122,949 Jobs
Director, Medical Zone
Landmark HealthRome, NY
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems is helpful.Last updated 4 minutes ago
Director Credentialing
Sharp HealthcareSan Diego, CA
Directs primary source verification and collection of documentation for licensing, board certifications, proof of professional liability insurance, National Practitioner Data Bank (NPDB) and/or other sources as required based on Joint Commission and NCQA standards, health plan requirements and credentialing policiesLast updated 4 minutes ago
Registered Nurse
Centene CorporationCamp Hill, PA
+ Participates in site visit preparation and execution by regulatory and accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA, EQRO).Last updated 9 minutes ago
Senior Clinical Quality Analyst, Operations Specialist - Boise, ID
UnitedHealth GroupBoise, ID
The Senior Clinical Quality Analyst is a key member of the Quality Management and Improvement (QMI) Department within the Idaho Behavioral Health Plan (IBHP) and has responsibility for ensuring all quality management and peer review functions are maintained in accordance with policy and NCQA standards.
Full-time
Last updated 9 minutes ago
Clerk
THE RIGHT STAFFGolden Valley, MN
G., MDH, NCQA) and applicable laws and regulations (e.Last updated 9 minutes ago
Associate Director Clinical Quality - Telecommute in MN
UnitedHealth GroupMinnetonka, MN
Job Keywords: Medicaid Director, Quality Director, Sr Director Quality, Director of Quality, Director, Quality, Clinical Quality, Medicaid, NCQA, Accreditation, Nursing, Project Management, HEDIS, MIPS, CMS, MN, Minnesota, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote
Remote
Last updated 9 minutes ago
Data
Wellmark Blue Cross Blue ShieldDes Moines, IA
Provide quantitative and qualitative analysis of HEDIS results, identify opportunities for improvement, and measure and analyze the interventions in support of NCQA accreditation.Expired 9 minutes ago
Credentialing Specialist - Remote
UnitedHealth GroupAtlanta, GA
Basic knowledge on NCQA, HIPAA
Full-timeRemote
Last updated 9 minutes ago
Credentials Coordinator - CVO, Full Time
Health FirstRockledge, FL
Complete the data gathering process for practitioner credentials files within the established guidelines for turnaround times, accuracy, and in accordance with external regulatory requirements including but not limited to The Joint Commission and CMS, NCQA, etc.
Full-time
Last updated 9 minutes ago
Director
Providence Health & ServicesBeaverton, OR
+ Must be able to show an understanding of the importance and impact of quality initiatives to PHP - such as NCQA, HEDIS, and Medicare Five Star - and demonstrate support and improvement where needed.Last updated 9 minutes ago
Medical Management Coordinator - ProHealth Physicians - Farmington, CT
UnitedHealth GroupFarmington, CT
We're also nationally recognized as a NCQA Level III Medical Home. That kind of progressive leadership makes us perfect fit for OptumCare and UnitedHealth Group's expanding family of providers.Last updated 9 minutes ago
CLAS Coordinator Specialist
AmerihealthManchester, NH
Maintains a comprehensive knowledge of Department of Health and Human Services (DHHS), National Committee for Quality Assurance (NCQA), Office of Minority Health (OMH) and other regulatory standards related to Cultural and Linguistically Appropriate Services activities.
Full-time
Last updated 9 minutes ago
Associate Vice President Care Management Operations 5000 SIGN ON
UnitedHealth GroupAmarillo, TX
The Vice President coordinates duties with appropriate personnel to meet operational program needs, ensures compliance with state and federal health plan requirements, Medicare guidelines, NCQA and URAC standards.Last updated 9 minutes ago
Senior Care Enrollee Services Representative - Remote
Fallon Community Health PlanWorcester, MA
To execute the following tasks in accordance with the Senior Care Option (SCO) contract requirements, CMS regulations, NCQA standards, departmental policies and procedures, and other applicable regulatory requirements: processing of enrollment applications handling of all enrollee inquires, including but not limited to Medicare and Medicaid benefits handling prospect inquires conducting telephonic enrollment conducting enrollment verification calls
Remote
Last updated 10 minutes ago
Coordinator
AmeriHealth CaritasManchester, NH
+ Maintains a comprehensive knowledge of Department of Health and Human Services (DHHS), National Committee for Quality Assurance (NCQA), Office of Minority Health (OMH) and other regulatory standards related to Cultural and Linguistically Appropriate Services activities.Last updated 10 minutes ago

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