- Highmark Health (Nashville, TN)
- …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
- Veterans Affairs, Veterans Health Administration (Murfreesboro, TN)
- …in a manner promoting success in all applicable performance measures and ensuring compliance with all applicable accreditation standards. Shall act in a ... Veterans Affairs Tennessee Valley Healthcare System, {VA TVHS). Incumbent provides comprehensive clinical services to Veterans and their families within the MHCL. VA… more
- CVS Health (Nashville, TN)
- …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
- Veterans Affairs, Veterans Health Administration (Nashville, TN)
- …plans for complex research studies/project for completeness, accuracy and ensures compliance with local and federal policies and regulations. Incumbent assigns ... the scientific methodology associated with the research project and the clinical and/or scientific expertise of the committee members ensuring the protection… more