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Ncqa standards Remote Jobs

14 fresh jobs found

Director, Utilization Management
Remote-OH, United States

Centene Corporation

Ncqa standards Provider experience Healthcare Management NCQA Utilization Medical management Performance Improvement Health Services Training and Development +27

Exec Senior Full Time

USD 124K+

Nurse Supervisor, Utilization Management Clinical Quality
Remote

Nurse Management HEDIS measures Clinical auditing Escalations RN licensure Insurance experience Ncqa standards Healthcare quality MCG +37

USD 88K+

Credentialing Specialist (Remote based in US)
United States

Tenet Healthcare

Credentialing Database Collaborative work Office Software Provider Enrollment Ncqa standards Healthcare Delivery Credentialing Revenue Cycle Management Revenue Cycle +17

USD 69K+

RN Clinical Review Clinician_Appeals
Remote-CA, United States

Centene Corporation

Appeals processes Interdepartmental Collaboration Ncqa standards Clinical reviews Medicaid regulations Researching NCQA Clinical Review Guidelines +27

USD 95K+

Lead Care Manager (RN)
Remote-WI, United States

Centene Corporation

Service plan Ncqa standards Quality care Personalized care plans NCQA Telephonic Outreach Training and education Healthcare outcomes Service plans +25

Senior Mid Full Time

USD 85K+

Supervisor, Clinical Grievance and Appeals
Remote-MO, United States

Centene Corporation

Appeals management Grievance Grievances Ncqa standards Quality Metrics NCQA Regulatory reporting Medical necessity Appeals +31

USD 68K+

Triage Nurse - RN - Evening Hours - 3pm-1:30am and Every other Weekend
Dayton WFH, United States

Health information service Decision support software Clinical triage Critical reasoning Nursing process URAC Proper grammar usage Decision support Ncqa standards +27

USD 61K+

Compliance Manager
Remote, California

Central California Alliance for Health

Regulatory audit AI software Medi-cal Ncqa standards Compliance management Healthcare Compliance Internal Audit Workflow Automation Public speaking +13

Senior Mid Full Time

USD 103K+

Director, Care Management
Remote-OK, United States

Centene Corporation

Clinical Care Pathways Information Technologies Provider experience Quality care Ncqa standards Staff training Budget development NCQA Healthcare outcomes +30

Exec Senior Full Time

USD 119K+

Manager, Care Management (RN)
Remote-NY, United States

Centene Corporation

Member Outreach Provider experience Quality care Ncqa standards NCQA Healthcare outcomes Data Reporting Policy Development Audits +26

Senior Mid Full Time

USD 100K+

Credentialing Specialist II
Seattle-600 University St., Ste. 400 (10345), United States

Centene Corporation

Provider data management Ncqa standards NCQA Credentialing Data processing Managed Care Health Insurance Data Management Flexibility +9

USD 77K+

Community Based Care Managers - Native American Focus - Must live in Mississippi
Mississippi WFH, United States

Person-Centered Care Planning Community Resource Education Behavioral health assessment Healthcare Resource Utilization Interdisciplinary Team Collaboration Ncqa standards Trauma-Informed Care Clinical Standards Health Equity +35

USD 55K+

Care Manager NICU - Must be LSW (Must live in Mississippi) WFH
Mississippi WFH, United States

Community Resource Education LSW Person-centered planning Healthcare Resource Utilization Interdisciplinary Team Collaboration Ncqa standards Clinical Standards Trauma-Informed Care Health Equity +36

USD 55K+

VP, PHCO Utilization Management Medicaid & Marketplace
Remote-MO, United States

Centene Corporation

Ncqa standards NCQA Clinical Training Financial Forecasting Provider Relations Acute care Marketplace Reconciliation Utilization Review +25

Exec Senior Full Time

USD 182K+

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