- UCLA Health (Los Angeles, CA)
- Description The NCQA and CMS Star Rating Program Manager will lead initiatives to drive the Medicare Advantage Plan's success in NCQA Health Plan ... Collect and prepare evidence to support survey readiness for NCQA Accreditation and CMS Star Ratings. +...Develop and track clear goals, timelines, and deliverables for program success. + Guide teams to maintain a culture… more
- Evolent (Washington, DC)
- …Senior Quality Specialist for Accreditation role will work closely with the NCQA Manager in collaboration with multiple departments in meeting the ... program and adherence to State, Federal, CMS, Accreditation ( NCQA and/or URAC), and contractual requirements.... requirements * Any other duties as assigned by Manager or Quality leadership **Qualifications - Required and Preferred:**… more
- Blue KC (MO)
- …discount program ** **Job Description Summary:** The Integrated Health Advancement Program Manager leads an integrated behavioral health and health outcome ... performance measurement, including design of incentive programs, HEDIS/STAR improvement efforts, and NCQA accreditation or Health Equity Accreditation +… more
- CareFirst (Baltimore, MD)
- …initiatives. Drives teams and internal projects to maintain and enhance program performance over time. Guides stakeholders through key decisions, communicates and ... and organizational metrics and performance. **ESSENTIAL FUNCTIONS:** + Manages DSNP & NCQA Health Plan that span organizational boundaries, and have a significant… more
- Fallon Health (Boston, MA)
- …provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for the Elderly)- in the region. ... and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary...for MassHealth programs such as the personal care attendant program , adult foster care, group adult foster care, and… more
- WellSense (NH)
- …manner and in keeping with contractual requirements, internal policy and NCQA accreditation standards. Facilitates multidisciplinary consultation on members' ... our members, no matter their circumstances. **Job Summary** The Clinical Care Manager provides holistic medical care management services for members throughout the… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you, we encourage you to apply! Job Description: This pharmacist clinician is a program manager , who is responsible for all Medicare Part D formulary creation ... while ensuring the longevity of the Plan's Part D program . Essential Accountabilities: + Develops and maintains the Part...and state regulatory agencies (CMS, DOH, DFS, etc.) and/or accreditation agencies ( NCQA , BCBSA) is preferred, but… more
- CVS Health (Carson City, NV)
- …+ Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (eg, NCQA , URAC, state and federal standards and ... do it all with heart, each and every day. ** Program Overview** Help us elevate our patient care to...new markets across the country. **Position Summary** The Associate Manager , Clinical Health Service will oversee the implementation of… more
- CVS Health (Baton Rouge, LA)
- …customer experience. + Ensure all activities are compliant with state, federal, and accreditation standards (eg, CMS, NCQA , URAC). + Collaborate with internal ... each and every day. **Position Summary** The Utilization Management Manager of Prior Authorization oversees a team of clinical...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- Chapa-De (Auburn, CA)
- …empowers teams and improves care at every level. The Quality Improvement Manager provides oversight and leadership on agency-wide quality and performance improvement ... Responsibilities: + Implements the Quality and Performance Improvement (QAPI) Program in alignment with the organization's mission, strategic goals, federal/state… more
- CVS Health (Austin, TX)
- …Implements clinical policies & procedures in accordance with applicable regulatory and accreditation standards (eg NCQA , URAC, state and federal standards and ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more
- Molina Healthcare (AZ)
- …* Participates in preparation for national committee for quality assurance ( NCQA ) and utilization review accreditation commission (URAC) certifications. * ... services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …as required by state and federal regulations, National Committee for Quality Assurance ( NCQA ) accreditation standards, and CPRC policies. + Collaborate with the ... CPR's Director and Clinical Lead, Operations Lead, Senior Credentialing Manager / Compliance Consultant, Risk Specialist, Exception Review Specialists and Project… more
- Fallon Health (Milford, MA)
- …provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for the Elderly)- in the region. ... delivery of items as part of the 'Oh Baby' program and work with Nurse Case Managers to coordinate...needs + The Navigator refers to the Nurse Case Manager /PCP whenever clinical decision making is required. **Responsibilities** **Note:… more
- Whitney Young Health Center (Albany, NY)
- …with local, State, and Federal regulation, ie DHHSHRSA and NYSDOH, and all accreditation standards (eg Joint Commission and NCQA -PCMH). + Adhere to the ... guidelines, policies and procedures. The Staff Pharmacist will also support the Pharmacy Manager in leading and directing the pharmacy team, by being accountable and… more
- Childrens Hospital of The King's Daughters (VA)
- …patient population program (Payer Programs, Primary Care Medical Home, NCQA accreditation ) and/or service. Ability to use various technologies, electronic ... quality or care coordination based data. Reports to Performance Improvement Manager . ESSENTIAL DUTIES AND RESPONSIBILITIES + Collaborates and coordinates program… more
Related Job Searches:
Accreditation,
Accreditation Program Manager,
Manager,
Program,
Program Manager