- CareFirst (Baltimore, MD)
- …Health Equity accreditation. Enhance program performance in preparation for NCQA submission. Guides stakeholders through key decisions, communicates and coordinates ... requirements. Supports the organization's understanding and compliance with current NCQA standards. **_Note: We are looking for an experienced professional… more
- The Boeing Company (Mesa, AZ)
- …& Security** (BDS) is seeking a **Numerical Control Quality Engineer - NCQA (Associate, Experienced or Senior)** to support the **Air Dominance Proprietary** team ... in **Mesa, Arizona** . **This position may be located on either 1st or 2nd shift and follows a 9/80 working schedule.** **This is at the hiring team's discretion and could potentially change in the future depending on the business needs.** This position will… more
- Baylor Scott & White Health (Dallas, TX)
- …regulatory requirements in programs including the National Committee for Quality Assurance ( NCQA ) accreditation (including ownership of the full NCQA HEDIS ... responsible for coordinating with external agencies and governing bodies, such as NCQA and CMS. Develop and communicate quality analytic business plans and… more
- Molina Healthcare (Columbus, OH)
- …Oversight Department. Oversees delegated activities to ensure compliance primarily with NCQA , CMS and State Medicaid requirements including delegation standards and ... that Molina Healthcare's UM delegates are compliant all applicable State, CMS, and NCQA requirements, as well as Molina Healthcare business needs. In addition, the… more
- University of Florida (Jacksonville, FL)
- …and experience. Job Description: + Develops and coordinates patient services to review NCQA standards. + Assists and support the Quality Officer to review and ... members of the patient's treatment team. Maintains all records and reports related to NCQA /PCMH and keeps track of data in an Excel spreadsheet. + Coordinates PCMH… more
- Albany Medical Center (Albany, NY)
- …working independently on a closing the caseload for providers and assists with the NCQA payor and delegation audits and routine monitoring on an ongoing and annual ... basis. This position will assist with NCQA and Payor QA audits and the communication to...onboarding and training of new credentialing associates to the NCQA and provider enrollment process + Expertise with … more
- Molina Healthcare (Columbus, OH)
- …adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA -compliant ... and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. + Reviews quality referred issues, focused… more
- Molina Healthcare (Columbus, OH)
- …adverse incidents and quality of care concerns. Participates in preparation for NCQA and URAC certifications. Develops and provides leadership for NCQA -compliant ... and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA and other regulatory requirements. + Reviews quality referred issues, focused… more
- Sharp HealthCare (San Diego, CA)
- …targets for initiatives such as National committee for Quality Assurance ( NCQA ); AlignMeasurePerform (AMP); Pay for Performance (P4P) metrics; Medicare Stars; HEDIS; ... Ensures department adheres to and maintains regulatory and legislative compliance from CMS, NCQA , DMHC, and other regulatory bodies related to PHM, CCM and DM.… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …program design and quality improvement initiatives as a consultant for NCQA accreditation standards (including monitoring for identification of risks and improvement ... The role serves as a resource regarding accreditation standards including NCQA standards and continuous quality improvement principles.This role also drives… more
- Commonwealth Care Alliance (Boston, MA)
- …operations and compliance of the Appeals and Grievances department through many NCQA and other related quality program activities including: monthly case quality ... and training and areas on noncompliance. In addition to NCQA program support, this role will also support compliance...Peer calls between requesting MDs and CCA MDs, per NCQA requirements. + Coordinate BOH hearings with external State… more
- Centene Corporation (Sacramento, CA)
- …in accordance with policies, guidelines, and National Committee for Quality Assurance ( NCQA ) standards. + Prepares case reviews for Medical Directors by researching ... processing, and response to appeal in accordance with State, Federal and NCQA standards + Communicates with members, providers, facilities, and other departments… more
- Centene Corporation (Raleigh, NC)
- …Conduct training and education programs for Plan, provider network, delegated vendors to support NCQA and HEDIS activities. + Develop QI, NCQA and HEDIS projects ... vendors to support accreditation maintenance and HEDIS reporting. + Coordinate assigned NCQA and HEDIS work plan activities. + Assist with delegation oversight… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a National Committee for Quality Assurance Specialist ( NCQA Specialist), to join us in leading our organization forward. McLaren Integrated HMO ... more about MDwise, Inc. at https://www.mdwise.org/ **Position Summary:** The NCQA Specialist coordinates quality improvement activities and supports various… more
- AmeriHealth Caritas (Columbus, OH)
- …improvement plan into all departments and facilitating HEDIS, CAHPS and NCQA accreditation activities.; Implements and supports the overall implementation of quality ... programs that meet or exceed applicable State, Federal and NCQA standards.;; Principal Accountabilities: + Executes on organizational efforts in ongoing quality… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Federal Employee Program (FEP) and National Committee for Quality Assurance ( NCQA ) accreditation standards, as appropriate to the member's case assignment. Uses ... of current Case Management Society of America (CMSA) Standards, NCQA Standards, Case Management Program activities, and performs the...requirements are being met, such as NYS DOH, CMS, NCQA , and HEDIS, serving as internal auditor within the… more
- TEKsystems (Baltimore, MD)
- …analysis of approved credentialing and re-credentialing files to determine compliance with NCQA guidelines and state regulations + Worked directly with IT to design ... and proposed updates to existing Credentialing Policies and Procedures based on NCQA guidelines and individual state regulations + Supported Director of Project… more
- BlueCross BlueShield of North Carolina (NC)
- …(ACOs) and independent primary care providers to promote quality improvement for NCQA Healthcare Effectiveness and Data Information Set (HEDIS) measures, MA Stars ... Data and Information Set (HEDIS) measures to maximize outcomes of NCQA accreditation, Medicare Stars, HEDIS Measure performance and improve provider satisfaction.… more
- Centene Corporation (Jefferson City, MO)
- …from inception to closure, including National Committee for Quality Assurance ( NCQA ) and Healthcare Effectiveness Data and Information Sets (HEDIS) performance ... to drive HEDIS and 5 Star project improvement activities. Ensures MRR efforts meet NCQA HEDIS audit standards. + Performs other duties as assigned + Complies with… more
- Sharp HealthCare (San Diego, CA)
- …collaboration necessary for the continuum of care foundation for our NCQA required population health management program. Additionally, this position provides the ... clinical teams. + Assists CMO in the implementation of NCQA top decile improvement programs and work plans. +...committees, and the SHP Chief Medical Officer. + Supports NCQA survey activities. Prepares for site visits and responds… more
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