- Molina Healthcare (Austin, TX)
- …management. **Job Duties** ** Program Oversight & Project Management** + Directs accreditation work plans and timelines to meet NCQA and contractual ... department or cross-functional teams of subject matter experts, delivering on NCQA accreditation requirements. Plans and directs schedules, reporting, process… more
- Baylor Scott & White Health (Temple, TX)
- …reports, metrics, and documentation on utilization performance indicators and NCQA accreditation and compliance requirements. Consults with physicians ... larger, more complex organization or functional area than a manager . Has multiple managers reporting to the role. ESSENTIAL...of managed care concepts. 6. Knowledge and experience managing NCQA accreditation standards. 7. Ability to work… more
- Health Care Service Corporation (Richardson, TX)
- …for managing the enterprise credentialing committee activities in compliance with accreditation standards and state regulations and managing the ongoing monitoring ... **Preferred Job Qualifications:** **Knowledge of Symplr Payer, PPW.** **Knowledge of NCQA , URAC, CMS, and state Departments of Insurance regulatory requirements.**… more
- Apex Health Solutions (Houston, TX)
- …it relates to CMS and other regulatory entities. Interacts with pharmacy benefit manager (PBM) to support the implementation of new pharmacy products or services and ... conduct frequent audits to ensure compliance with regulatory entities such as CMS, NCQA , URAC. Intervenes, as necessary, to resolve member or provider issues with… more