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Full Time Ncqa Jobs (NOW HIRING)

Charlie Health

Credentialing Manager

New York, NY · Remote

Manage required payor audits and internal audits to ensure ongoing NCQA and delegated credentialing ... full-time, exempt employees. Read more about our benefits here. Please note that this role is not ...

Charlie Health

Credentialing Manager

Nashville, TN · Remote

Manage required payor audits and internal audits to ensure ongoing NCQA and delegated credentialing ... full-time, exempt employees. Read more about our benefits here. Please note that this role is not ...

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How much do full time ncqa jobs pay per hour?

As of Jul 23, 2026, the average hourly pay for full time ncqa in the United States is $23.59, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $26.20 per hour, depending on experience, location, and employer.
What are the most commonly searched types of Ncqa jobs? The most popular types of Ncqa jobs are:
Full Time Ncqa jobs near you
Infographic showing various Full Time Ncqa job openings in the United States as of July 2026, with employment types broken down into 74% Full Time, 24% Part Time, and 2% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $49,069 per year, or $23.6 per hour.

Quality Management Clinician (Hybrid)

UPMC Senior Communities

Tobyhanna, PA • On-site

$27.89 - $48.21/hr

Full-time

Posted 23 days ago

Job description

UPMC Community Care Behavioral Health is hiring a full-time Quality Management Clinician to join the Quality team. This role will work in a hybrid structure with 3 days in the office in Tobyhanna each week. Occasional local travel may be needed at times.
The Quality Management Clinician is responsible for performing functions related to quality management and improvement, in compliance with NCQA, HEDIS, URAC and the Commonwealth of Pennsylvania Department of Health quality assurance regulations.
Responsibilities:
  • Responsible for participating in projects as designated by other management staff, such as the Chief Medical Officer and VP of Medical Affairs.
  • Responsible for performing targeted, clinical audits and focus studies.
  • Responsible for logging in, tracking, monitoring, and reporting individual and aggregate complaints and grievances to the Senior Director of Quality Management and other leadership staff members as appropriate. Prepares formal reports and tracks timing of various levels of complaint and grievance for further action.
  • Responsible for assisting with preparation for NCQA, URAC, and other site visits.
  • Responsible for participating in updating the QM Plan.
  • Responsible for monitoring quality tracking reports and providing individual feedback to appropriate staff/committees, and aggregating the data on a monthly basis.
  • Responsible for identifying trends related to product and participating providers.
  • Responsible for preparing monthly and quarterly quality improvement reports to the Board.
  • Responsible for specified data collection related to all functional departments of Community Care.
  • Responsible for assisting with training responsibilities for providers, Members, and staff on various issues as assigned by the Senior Director of Quality Management.
  • Responsible for professional and staff development plan.

Qualifications:
  • Licensed Registered Nurse or Masters Degree required
  • 3 years clinical experience required.
  • Prior behavioral health/mental health experience or education strongly preferred.
  • Experience in Quality Management procedures/processes is a bonus.
  • Knowledge of URAC, NCQA and HEDIS standards is a bonus.
  • Excellent organizational skills.
  • Experience in report writing, Microsoft Access, Microsoft Excel, collection and organization of large quantities of data.
  • Ability to maintain effective professional liaison with all levels of staff, including professional and institutional providers of care.
  • Independent problem solving related to job responsibilities based on knowledge of quality standards, clinically pertinent issues related to product and population served, and the operating practices of this organization.
  • Ability to identify trends or problem areas.
  • Demonstrates clinical knowledge of behavioral health related issues.
  • Ability to propose and, with supervision, implement solutions to identified trends or problem areas with recommendations for improvement.
  • Excellent clinical, written and oral communication skills.
  • Responsiveness to deadlines and has work completed on or before deadline 95% of the time.
    Licensure, Certifications, and Clearances:
  • Pennsylvania licensure: LSW, LCSW, LPC, licensed MFT, licensed RN (with BSN) and/or a licensed PhD (psychologist) is a bonus.
    UPMC is an Equal Opportunity Employer/Disability/Veteran

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