ncqa jobs in Houston

WNS, part of Capgemini, seeks a senior Quality Management and Compliance leader to drive accreditation readiness and oversight across URAC/NCQA standards. You will lead audits, develop KPIs, and partner with operations, compliance, and IT to sustain corrective actions in a fast-paced health plan environment. The role requires RN licensure, 5+ years in...

Child & Adolescent Psychiatry opening in Houston, TX Part-time, permanent position Outpatient Primary care FQHC site Multicultural, multilingual patient population Bilingual (Spanish/ English) preferred Competitive compensation and benefitsAbout the facility:Over the years the facility has expanded its focus to include the overall health of residents of the...

WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered...

Medical DirectorOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion,...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Director of Payer Credentialing & Provider Enrollment Location: Houston, TX Job Type: Full-time Work Schedule: Onsite About PsychPlus PsychPlus is one of the largest private psychiatry and behavioral health organizations in the U.S., providing comprehensive mental health services through psychiatry, therapy, and innovative treatment programs. About the...

WNS, part of Capgemini, seeks a senior Quality Management and Compliance leader to drive accreditation readiness and oversight across URAC/NCQA standards. You will lead audits, develop KPIs, and partner with operations, compliance, and IT to sustain corrective actions in a fast-paced health plan environment.The role requires RN licensure, 5+ years in...

Medical Director, Transplantation And Cellular TherapiesOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you...

Medical Director, Transplantation And Cellular TherapiesOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you...

Senior Medical Assistant Certified- Urology (West Houston/ Katy) At Houston Methodist, the Senior Medical Assistant Certified (Sr. MA) position is responsible for functioning as an expert and demonstrates highly competent knowledge in the more technical and advanced examinations and treatments necessary to communicate appropriately and carry out delegated...

WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence - WNS’ core differentiator - with AI-powered...

We are searching for a Centralized Credentialing Manager – someone who works well in a fast-paced setting. In this position, you’ll be responsible for maintaining the Practitioner and Facility Credentialing Program for Texas Children's Medical Staff and Texas Children's Physician Group (TCPSO). This role will be primarily responsible for maintaining...

UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years...