- UpvoteDownvoteShare Job
- Suggest Revision
NCQA, URAC and/or HEDIS accreditation experience strongly preferred. SummaryLocation: Renton, WA; Salt Lake City, UT; Medford, OR; Coeur d'Alene, ID; Lewiston, ID; Boise, ID; Burlington, WA; Bend, OR; Remote; Portland, OR; Utah; Yakima, WA; Tacoma, WA; Oregon; Spokane, WA; Washington; Idaho; Pocatello, ID; Salem, ORType: Full time.
$150,000 - $245,000 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Awareness about UM standards, NCQA requirements, CMS guidelines, Milliman guidelines, and Medicaid/Medicare contracts and benefit systems. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management policy, clinical protocols, utilization management guidelines, and quality management programs.
Full-timeExpandApply NowActive JobUpdated 4 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. Licensed Social Worker (LSW) Advises and educates Provider practices in appropriate HEDIS measures and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Ensure day-to-day processes are conducted in accordance with nationally accepted standards (NCQA, URAC, and other regulatory standards) and for IDS Members, the contract held between OHSU Health Services and Health Share of Oregon.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Monitor and promote improvement or maintenance of local/federal clinical performance metrics and certifications (ie HRSA, NCQA, PCPCH, CCO) within CCC’s Primary Care programs. Monitor and promote improvement or maintenance of local/federal clinical performance metrics and certifications (ie HRSA, NCQA, PCPCH, CCO) within CCC’s Primary Care programs.
Full-timeExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Preference for experience with Medicare Star ratings, Medicaid quality initiatives, and NCQA standards. Manage interface between vendor/consultant/client to ensure efficient coordination and implementation of coding, including appropriate oversight and monitoring of all PBM operations, data interfaces, and external communications.
Full-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Strong understanding of healthcare quality measures, including NCQA HEDIS measures, measures derived from EHR and other standardized datasets, administrative data, and public health databases. Manage the process of NCQA certification for HEDIS measures, including data collection, submission, and validation.
RemoteExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
- Suggest Revision
PMHNP should be: Legally licensed to practice medicine in Oregon State; license and DEA certificate in good standing; ability to meet necessary privileging and credentialing criteria (JCAHO and NCQA.
ExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Psychiatrist should be: Legally licensed to practice medicine in Oregon State; license and DEA certificate in good standing; ability to meet necessary privileging and credentialing criteria (JCAHO and NCQA.
ExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of regulations and standards regarding nursing and healthcare facilities (e.g. The Joint Commission, NCQA, etc.) Knowledge of regulations and standards regarding nursing and healthcare facilities (e.g. The Joint Commission, NCQA, etc.
ExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
Overview The Integrated Community Care Manager-RN provides one-site (face-to-face) and telephonic outreach, behavioral health, disease and/or care management, care coordination, care integration, care transition, education, support and navigation to OHSU Health Services Members with the goal of supporting healthy life choices and to reduce long term effects of chronic illness.
$49.16 - $78.18Full-timeExpandUpdated 26 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Supports wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement. Knowledge of medical terminology, health care coding systems such as ICD-10, CPT and HCPCS and HIPAA regulations.
ExpandUpdated 13 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Working knowledge of NCQA, the Centers for Medicare and Medicaid Services and Oregon Health Authority or other state credentialing standards helpful. Job Summary: Performs all verification activities associated with credentialing and re-credentialing Moda contracted providers in accordance with Moda policies, National Committee for Quality Assurance (NCQA) standards and state and federal requirements.
$18.03 - $22.32 an hourFull-timeExpandUpdated Today - UpvoteDownvoteShare Job
- Suggest Revision
3+ years of experience with CMS, Medicaid and State(s) regulatory requirements and quality accreditation bodies - NCQA and/or URAC. 3+ years of experience with CMS, Medicaid and State(s) regulatory requirements and quality accreditation bodies - NCQA and/or URAC.
RemoteExpandUpdated 7 days ago - UpvoteDownvoteShare Job
- Suggest Revision
Knowledge of current credentialing regulations and requirements; NCQA, Medicare and Medicaid. Participate in delegation oversight process, including data entry and audit process, as directed by the Credentialing Supervisor.
Full-timeExpandUpdated 10 days ago
ncqa job in Beaverton, OR
FEATURED BLOG POSTS
6 Common Mistakes to Avoid When Employer Branding
Currently, job searchers are putting extra effort into researching employers. The information they find plays a major role in whether they will pursue an opportunity with you or look for jobs elsewhere. That is why it is now more important than ever to be proactive and intentional when showcasing your workforce and workplace culture. Having a well crafted employer branding strategy can help you strategize and influence your potential candidates so they see your business in the best light. But in order to do that, you should be aware of some of the most common mistakes that employers make.
What to Say When Terminating an Employee
Terminating an employee is an inevitable part of doing business. Whether you’re re-structuring your department or you’ve identified a few employees who’re not living up to your expectations, letting people go is necessary for keeping your workforce healthy and thriving.
How to Utilize Keywords for Your Job Ads
Before we give you the scoop on how to utilize keywords in job ads, it would be helpful if we defined what keywords are and why they are important. In simple terms,
What Makes a Good Paid Time Off (PTO) Policy
The world of work has undergone some major transformation in recent years. From remote and flexible work to increased emphasis on employee benefits and wellbeing, companies nowadays have to be very intentional about their HR policies and how they approach talent acquisition.
Internal Recruiting: Benefits and 5 Internal Recruiting Methods to Consider
Internal and external recruiting are nearly the same thing. The biggest difference is where candidates are sourced. There are instances where external recruiting may be the best option. However, when you are presented with the opportunity to recruit internally, you should take full advantage of the different internal recruiting methods. Initially you will find that the hiring process gets a little bit easier. Then you'll notice all the other benefits that internal recruiting offers.
How to Answer the Interview Question: What is Your Communication Style?
As a job searcher, you probably have so many questions about job searching. However, once you've landed an interview, your excitement takes your questions to a whole new level. What will you wear? Will you know how to answer all the questions? Have you practiced giving nice firm handshakes?
What Makes a Company a Great Place to Work
After one too many after-hours emails, you’re on the hunt for a new gig. But what makes a company a great place to work? And how will you know when you find one? Finding a motivating, safe, and productive work environment is important for our mental and physical health. If you’re financially frustrated, creatively stuck, or just plain over it, it’s time to find a healthier workplace where you can flourish.