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Ncqa Accreditation Jobs (NOW HIRING)

SF Health Plan

Program Manager, NCQA

San Francisco, CA · Hybrid

$90K - $105K/yr

You will manage and lead activities associated with SFHP's NCQA Accreditation. These activities include ongoing monitoring and analysis of plan performance against the NCQA standards. Additionally ...

Bcbsa

Accreditation Program Specialist

Chicago, IL · Hybrid

Acts as the primary resource and administrator for NCQA's Interactive Survey Tool, and URAC's web-based application (e.g., AccreditNet) used for evidence of accreditation compliance. Serves as ...

Phsorg

Responsible for the annual HEDIS submission, PHP Medicare Star Program Ratings, NCQA accreditation, and regulatory and contractual compliance. * Directs the activities for Performance Improvement ...

Dignity Health

Senior Compliance Specialist

Phoenix, AZ · Remote

$39.18 - $58.28/hr

Deep understanding of federal and state laws (CMS, DMHC, DHCS) and NCQA accreditation standards. * Technical Proficiency: Advanced skills in Google Workspace (Docs, Sheets, Slides) and data analysis.

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How much do ncqa accreditation jobs pay per hour?

As of Aug 30, 2026, the average hourly pay for ncqa accreditation in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

What is an NCQA Accreditation?

An NCQA Accreditation job involves ensuring that healthcare organizations comply with the National Committee for Quality Assurance (NCQA) standards. Professionals in this role manage the accreditation process, conduct quality assessments, and implement policies to meet NCQA requirements. They collaborate with healthcare teams to improve patient care and organizational performance. Strong knowledge of NCQA guidelines, healthcare regulations, and quality improvement practices is essential for success in this role.

What are the key skills and qualifications needed to thrive in the NCQA Accreditation position, and why are they important?

To excel in NCQA Accreditation roles, you need a strong understanding of healthcare quality standards, accreditation requirements, and regulatory compliance, typically backed by clinical or health administration experience. Familiarity with NCQA guidelines, audit tools, tracking software, and industry certifications (such as Certified Professional in Healthcare Quality, CPHQ) is vital. Excellent analytical skills, attention to detail, and the ability to collaborate with interdisciplinary teams are soft skills that distinguish top candidates. These abilities are crucial for ensuring organizations meet or exceed accreditation standards, which directly impacts care quality and organizational reputation.

What are some common challenges faced in an NCQA Accreditation role, and how are they typically addressed?

Professionals working in NCQA Accreditation often encounter challenges such as keeping up with regularly updated accreditation standards, ensuring complete and accurate documentation, and coordinating compliance efforts across multiple departments. Addressing these challenges typically involves ongoing education, strong project management skills, and fostering open communication between clinical, quality, and administrative teams. Many organizations support their accreditation staff with cross-functional training sessions and regular updates on evolving compliance requirements. By being adaptable and proactive, team members can efficiently navigate these challenges and contribute to the organization's continuous quality improvement initiatives.

How do you become NCQA accredited?

To become NCQA accredited, an organization must meet specific standards by completing an application, submitting documentation demonstrating compliance, and undergoing an on-site review. The process often involves preparing evidence of quality improvement efforts, staff training, and data management systems to ensure adherence to NCQA's criteria.
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Ncqa Accreditation jobs near you
Infographic showing various Ncqa Accreditation job openings in the United States as of August 2026, with employment types broken down into 3% As Needed, 77% Full Time, 19% Part Time, and 1% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Program Manager, NCQA

San Francisco Health Plan

San Francisco, CA • On-site

$90K - $105K/yr

Full-time

Medical, Dental, Retirement, PTO

Re-posted 10 days ago

Job description

Reporting to the Director, Regulatory Affairs, the NCQA Program Manager is an experienced healthcare professional. You will manage and lead activities associated with SFHP's NCQA Accreditation. These activities include ongoing monitoring and analysis of plan performance against the NCQA standards. Additionally, the manager coordinates all NCQA-related activities across the organization. The goal of these efforts is to maintain and prepare for ongoing NCQA accreditation and future categories of NCQA accreditation.
Position activities involve frequent daily interface with SFHP internal departments to support NCQA accreditation standards. Be the departmental contact for all matters related to NCQA accreditation. We are looking for someone who can manage a dynamic workload and adapt to evolving needs. And works independently while also motivating and supporting others.
Please note that while SFHP supports a hybrid work environment, you are required to be onsite and in-office a minimum of 4 days per month. This is a hybrid position, based in our Downtown San Francisco office.
Salary: $90,000 - $105,000 per year
WHAT YOU WILL DO:
  • Responsible for project timelines and professional inquiries, submissions and responses to NCQA.
  • Lead the NCQA-impacted department communications and activities.
  • Transition our framework from obtaining NCQA accreditation as a project to an ongoing operational effort to maintain NCQA accreditation through the renewal process.
  • Manage the accreditation processes and resources required to renew SFHP's accreditation status, including working with staff to ensure the submission of HEDIS and CAHPS data for the renewal survey.
  • Evaluate, interpret, and summarize accreditation guidelines at least annually. Manage the process for accreditation activities, including communicating year-to-year changes in the standards. Assist departments with updating policies, procedures, workflows, and reports, and to comply with updated standards.
  • Identify appropriate resources and accountabilities within departments involved with accreditation and ensure engagement by all impacted departments.
  • Lead coordination and communication with NCQA consultants.
  • Conduct the ongoing evaluation and interpretation of accreditation standards to ensure compliance through department leads, reporting and measurement studies/ methodologies.
  • Be an expert resource to internal staff across the organization.
  • Facilitate project management and develop comprehensive accreditation work plans by establishing deliverables, accountabilities, and timelines.
  • Work in collaboration with the Compliance team to monitor activities for compliance with NCQA standards together with compliance activities related to compliance with state regulatory and contractual requirements.
  • Inform and train staff on changes in NCQA accreditation standards and tools.
  • Refer substantive questions, important business issues to subject matter experts and follow up to ensure resolution and escalates.
  • Assess problems and develop solutions following general procedures and escalate to manager.
  • Assist manager with budget related to NCQA expenses, including processing invoices and variance reports.
  • Lead efforts to manage projects for implementing DHCS, CMS, and DMHC All-Plan Policy letters on an as-needed basis.

WHAT YOU WILL BRING:
  • Bachelor's degree or equivalent work experience
  • 3 or more years of experience Project management experience
  • Successful NCQA accreditation process completion and continuous process improvement experience in an NCQA setting
  • Experience analyzing and providing guidance on studies that go along with NCQA
  • Possess a strong quality improvement background that includes managed care and NCQA, specifically within the Medicaid and government-sponsored programs environments.

WHAT WE OFFER:
  • Health Benefits
    • Medical: You'll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
    • Dental: You'll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
    • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
  • Retirement � Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
  • Time off � 23 days of Paid Time Off (PTO) and 13 paid holidays.
  • Professional development: Opportunities for tuition reimbursement, professional license/membership.

ABOUT SFHP:
Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.
San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
San Francisco Health Plan is an E-Verify participating employer.
Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.
#LI-Hybrid
(Hybrid remote/in-office)

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