• Program Manager ( NCQA

    Molina Healthcare (Chicago, IL)
    …Assigns, directs, and monitors analysis and program staff according to NCQA Health Plan Accreditation standards. This position's primary focus is around ... through the design process to completion. Plans and directs schedules for NCQA Accreditation efforts. Monitors the project from inception through delivery.… more
    Molina Healthcare (10/06/24)
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  • Staff VP Accreditation & Quality Programs

    Elevance Health (Chicago, IL)
    accreditation efforts. + Develops and executes comprehensive strategy to improve Commercial NCQA Accreditation status, NCQA Star Ratings, Exchange Quality ... Program (QCR). + Develops and executes health disparity reduction efforts and attain NCQA Accreditation for Health Equity, HE+ if business required. + Serve… more
    Elevance Health (10/17/24)
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  • Manager , Accreditation & Regulatory…

    Cambridge Health Alliance (Cambridge, MA)
    Manager , Accreditation & Regulatory Compliance Apply Refer a Friend Back **Date Posted:** 11/12/2024 **Requisition Number:** 8693 **Location:** 1035 Cambridge ... Patient Safety, and working collaboratively with Quality and Safety leadership, the Manager , Accreditation & Regulatory Compliance leads efforts to ensure… more
    Cambridge Health Alliance (10/26/24)
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  • Registered Nurse (RN) Care Manager

    Whitney Young Health Center (Albany, NY)
    …regulation (FQHC), ie DHHS HRSA, CMS guidelines, and NYSDOH (article 28), and all accreditation standards (eg Joint Commission and NCQA -PCMH). + Adheres to the ... Registered Nurse (RN) Care Manager (Req 100826) Albany, NY (http://maps.google.com/maps?q=920+Lark+Drive+Albany+NY+USA+12207) Apply Description GENERAL… more
    Whitney Young Health Center (10/29/24)
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  • Care Management Initiatives Program

    LA Care Health Plan (Los Angeles, CA)
    Care Management Initiatives Program Manager II Job Category: Clinical Department: Care Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time ... safety net required to achieve that purpose. Job Summary The Care Management Initiatives Program Manager II is responsible for leading and managing a portfolio… more
    LA Care Health Plan (10/12/24)
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  • Clinical Appeals Manager - RN (Hybrid)

    CareFirst (Baltimore, MD)
    …expectation of a fair and compliant appeal process for our membership, and support NCQA accreditation and the Divisional Goals for the Clinical Appeals and ... CareFirst Medical Policy and are compliant with State, Federal and accreditation requirements. Ensures appropriate and complete resolution of appeals, Regulatory… more
    CareFirst (11/09/24)
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  • Manager Medical Management Innovation Care…

    HonorHealth (Scottsdale, AZ)
    …Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Medical Management Program Manager will be responsible for overseeing all the Medical ... daily operations and processes to ensure adherence to all NCQA and Medical Management department policies and procedures. The... and Medical Management department policies and procedures. The Manager will provide oversight for all PA/UM staff, and… more
    HonorHealth (10/25/24)
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  • Regulatory Operations Project Manager II

    LA Care Health Plan (Los Angeles, CA)
    Regulatory Operations Project Manager II Job Category: Administrative, HR, Business Professionals Department: Compliance Location: Los Angeles, CA, US, 90017 ... required to achieve that purpose. Job Summary The Regulatory Operations Project Manager II manages a portfolio of complex regulatory change management and compliance… more
    LA Care Health Plan (08/29/24)
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  • Medical Staff Specialist (1.0)

    Billings Clinic (Billings, MT)
    Accreditation Hospital Organizations (JCAHO) and National Committee Quality Assurance ( NCQA ) accreditation standards relating to medical staff organization, ... with credentialing policies can result in loss of or lowered facility accreditation status (ie, JCAHO and NCQA ). * Credentialing/privileging functions for… more
    Billings Clinic (10/08/24)
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  • Senior Medical Director - Sharp Health Plan

    Sharp HealthCare (San Diego, CA)
    …cohesive collaboration necessary for the continuum of care foundation for our NCQA required population health management program . Additionally, this position ... needs of the membership. Serves as a lead medical manager and policy advisor to SHP clinical and its'...+ Plans, organizes, and directs the professional medical services program , consisting of all primary and specialty services for… more
    Sharp HealthCare (10/20/24)
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