- Highmark Health (Hartford, CT)
- …Description :** **JOB SUMMARY** This job is responsible for working with HHO clinical departments in the areas of compliance and process improvement. Serves ... as a corporate resource regarding accreditation standards, clinical performance and continuous improvement...maintenance of Care Management policies and procedures to ensure accreditation and compliance with NCQA and DMMA… more
- Hartford HealthCare (Hartford, CT)
- …This includes credentialing and privileging functions related to the appointment/reappointment/ clinical privileges of practitioners to the Medical Staff in ... if applicants meet the qualifications and criteria for membership and/or clinical privileges. Notify Director/Manager of MSS, Department Chief, Medical Director,… more
- Eastern Connecticut Health Network (Manchester, CT)
- …POSITION SUMMARY: Coordinates the activities of the Credentialing Program in compliance with state, federal and Joint Commission standards. Coordinates the ... requests and performs primary source verifications for appointment, reappointment, clinical privileges, and temporary privileges in accordance with medical staff… more
- CVS Health (Hartford, CT)
- …clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits. + Applies clinical judgment to the incorporation of strategies designed to reduce risk… more
- CVS Health (Hartford, CT)
- …clients - Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors… more