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VA MCD Prov Relation Liaison
Aetna - 2,438 reviews - Chantilly, VA
Identifies opportunities for process improvement and works cross-functionally within the organization to gain desired outcomes regarding provider service issues...
Lead Medical Management, Health Services, SHP
Responsibilities include collaborating with the compliance department to effectively integrate and implement processes consistent with health plan requirements,...
Business Intelligence Developer/Team Lead (Business Informat...
Anthem, Inc. - 2,307 reviews - Deerfield, IL
This position is located in Deerfield, Illinois Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies

HEDIS Patient Care Advocate

TotalMed - Louisville, KY
$20 - $26 an hour
Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements. Coder, LPN, Medical Assistant....
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Grievance/Appeals Analyst I/II

Anthem, Inc. - 2,307 reviews - Richmond, VA  +1 location
The file review components of the URAC and NCQA accreditations are (must pass) items to achieve the accreditation....

Credentialing Specialist

West Gray Medical Office Management Services, Inc. - Norman, OK
$10 - $13 an hour
The Credentialing Specialist is responsible for all aspects of the credentialing, re-credentialing, and privileging processes for all medical providers with
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Quality Appeals Analyst - Rockville, MD

Kaiser Permanente - 5,276 reviews - Rockville, MD
Minimum three (3) years of experience auditing compliance to NCQA, Medicare or Medicaid standards. The Quality Analyst is accountable for ensuring compliance...

Quality Specialist (CME)

Kaiser Permanente - 5,276 reviews - San Jose, CA
Current knowledge of The Joint Commission, NCQA, federal, state, & local requirements. Ensures they are in compliance with The Joint Commission, NCQA, CME,...

WIC Clerk

Primary Health Solutions - 10 reviews - Hamilton, OH 45011
PHS is a nationally recognized NCQA Level III patient centered medical home providing the highest quality of care to the patients within our network....
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Health Plan Representative - Grade 303

Kaiser Permanente - 5,276 reviews - Mountain View, CA
Position(s) located within the local area Member Services Department reporting to Member Services Operations Director. Educates providers, staff and members

Quality Analyst

Kaiser Permanente - 5,276 reviews - Los Angeles, CA
Significant knowledge of TJC, Title 22, NCQA and CMA standards and requirements, TQM and tools for indicator development and display....

Patient Care Coordinator Case Manager

Kaiser Permanente - 5,276 reviews - Sacramento, CA  +1 location
Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPPA, ERISA, EMTALA & all other applicable federal/state/local laws & regulations....

Credentialing Specialist

Hennepin County - 169 reviews - Minneapolis, MN
$37,706 - $56,472 a year
Enter and maintain credentialing data in eVIPs following NCQA standards, as well as state and federal requirements....
Behavioral Case Manager
Understand and comply with NCQA guidelines and HEDIS measures. Perform duties related to the day to day operations of the Integrated Case Management functions...
Director, Case Management (Medicare)
Ensure compliance with Corporate, State and NCQA standards. Responsible for defining and directing a complete Case Management Program in conjunction with...

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