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Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards. - Knowledgeable of NCQA and ICE preferred. The Utilization Review RN Coordinates continuing care/outside services for value based risk members (HMO members) in collaboration with the hospital and primary care physician.
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Must have a National Provider Identification (NPI) number or be eligible and interested to register for an NPI number. Zeel is a leading provider of healthcare services, including musculoskeletal pain therapy and behavioral therapy.
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This role, Network Compliance Auditor (FSR) Nurse, performs all aspects of a Facility Site Review (FSR), using regulatory requirements, to test, monitor, document and report the overall level of compliance of the First Tier, Downstream and related entities (FDR) to ensure compliance with all applicable requirements; SCAN, Federal, State and National Committee for Quality Assurance (NCQA) requirements.
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Our Behavioral Healthcare Provider (BHP), a LCSW, or a LMFT, or a LPC, is an integral part of developing and delivering a personal care plan ensuring high quality, clinically appropriate, team-based behavioral health care.
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SAC Health System is recognized as a Level-3 Patient-Centered Medical Home by the National Committee for Quality Assurance (NCQA). This whole-person, full-scope, team-based approach is what makes SAC Health System the provider of choice for patients.
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The Coder 1 – Risk Adjustment is responsible for concurrent, prospective, and retrospective clinical documentation review as it pertains to Risk Adjustment Data Validation (RADV) timelines, with an emphasis on completeness and accuracy of provider documentation related to severity of illness and supporting clinical care plan(s) for the validation of Hierarchical Condition Category (HCC) diagnoses.
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Healthcare: SAC Health System is recognized as a Level-3 Patient-Centered Medical Home by the National Committee for Quality Assurance (NCQA). Title Family Medicine Physician - SAC Health System - Blythe Description Family Medicine Physician Opportunity Loma Linda University Faculty Medical GroupSAC Health System Loma Linda University Faculty Medical Group, Department of Family Medicine, has an immediate need for a Physician to join our team at SAC Health System.
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MHM Services, a Centurion company, is proud to be the provider of mental health services to the California Department of State Hospitals Conditional Release Program (CONREP). Active professional license or Associate License in Psychology, Social Work or Counseling in the state of California or pursuing licensure: PsyD, ACSW, LMFT, LCSW, LMSW, etc.
$77,000 - $131,000 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The role of the Surgical Sales Director, Physician and Provider Relations (Sales), is responsible for developing and retaining customer relationships to drive business growth for key hospital surgical service lines.
$93,828.8 - $135,844.8 a yearExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Area Chief of Staff partners with the Practice Manager (if applicable) to drive the culture and delivery of quality care by the veterinary provider team (DVM, CVT, VA) in their assigned hospitals to ensure that every pet receives consistent care aligning with our six domains of quality (safe, effective, patient/client centered, timely, efficient and equitable care.
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TORCHSTAR CORP is the leading distributor of the lighting industry and a full spectrum illumination solution provider in the U.S. As a provider of customized supply chain solutions, the company serves customers in many B2B and B2C market segments including industrial lighting, commercial lighting, remodeling, residential lighting, and specialty lighting.
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During its more than 35 years in business, CCW has become known as a full-service provider of transit repair solutions. Our line of transit services includes rebuilds, repowering, retrofits, CNG conversions & re-tanking, body work, painting, collision repair, and fire repair.
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Riverside, CA – Seeking Correctional Health Advanced Providers Become a Valued Member of Your Emergency Team As an Advanced Provider you play a critical role in improving the level of care within Correctional Health.
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License, Certification, Registration Licensed Marriage and Family Therapist (California) OR Licensed Professional Clinical Counselor (California) OR Licensed Clinical Social Worker (California) National Provider Identifier Additional Requirements: Knowledge of and ability to utilize current DSM nomenclature required.
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Acquires, maintains, teaches and demonstrates knowledge of Prevention of Sexual Abuse (PSA) and Sexual Harassment standards at care provider facilities, evidence-based practices, and trauma-informed care and maintains a professional environment that is consistent with Title 22, licensing regulations, and established agency policies.
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provider ncqa jobs in Loma Linda, CA
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