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Ncqa Accreditation Consulting Jobs (NOW HIRING)

Independence Blue Cross

Clinical Appeals Coord

$22.50 - $28/hr

... consultants or Medical Directors. • Coordinate and document matched-specialty reviews, peer ... with NCQA accreditation audits, state Department of Insurance audits, internal quality audits ...

Byrne Dairy

Medical Director (New York)

Syracuse, NY · On-site

$120 - $160/hr

Participates in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership and consultation for NCQA ...

Spectrum Health

Member Appeal Analyst

Grand Rapids, MI · On-site

  • Medical

  • Vision

  • Retirement

Ensure compliance with all mandated, legislative, regulatory and accreditation requirements. Assist ... acts as a consultant to internal and external customers in order to resolve complex issues

Healthcare Support Staffing

Quality Improvement LVN

Cypress, CA · On-site

$29.25 - $39.25/hr

  • Medical

  • Dental

  • Vision

Connect with one of our Professional Recruiting Consultants today to see how a conversation can ... accreditation agencies (State agencies, CMS, AAAHC, URAC, NCQA,EQRO) Hours for this Position:

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Ncqa Accreditation Consulting information

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How much do ncqa accreditation consulting jobs pay per hour?

As of Aug 19, 2026, the average hourly pay for ncqa accreditation consulting 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 NCQA accreditation consulting?

NCQA accreditation consulting involves helping healthcare organizations prepare for and achieve accreditation from the National Committee for Quality Assurance (NCQA). Consultants guide organizations through the complex requirements, documentation, and process improvements needed to meet NCQA standards. They provide expertise on policies, procedures, and best practices to ensure compliance and maximize accreditation outcomes. This support can increase an organization's efficiency, credibility, and ability to deliver high-quality patient care.

What are the key skills and qualifications needed to thrive as an NCQA accreditation consultant?

To thrive as an NCQA Accreditation Consultant, you need in-depth knowledge of NCQA standards, quality management, and healthcare regulatory compliance, often supported by a clinical or health administration degree and relevant certifications. Familiarity with audit tools, accreditation management systems, and healthcare data analytics platforms is crucial. Exceptional communication, analytical thinking, and project management skills help consultants effectively guide organizations through complex accreditation processes. These competencies ensure accurate interpretation of standards, efficient project execution, and successful accreditation outcomes for healthcare organizations.

What are some common challenges faced by professionals in NCQA accreditation consulting, and how can they be addressed?

Professionals in NCQA Accreditation Consulting often encounter challenges such as navigating complex and frequently updated accreditation standards, ensuring clients maintain compliance across all departments, and aligning organizational processes with NCQA requirements. To address these challenges, consultants must stay up-to-date with the latest NCQA guidelines, develop strong project management and communication skills, and work collaboratively with client teams to implement sustainable quality improvement strategies. Engaging in regular training and leveraging peer networks can also help consultants effectively guide organizations through the accreditation process.

What is the difference between Ncqa Accreditation Consulting vs Ncqa Accreditation Specialist?

AspectNcqa Accreditation ConsultingNcqa Accreditation Specialist
CredentialsTypically requires industry experience, knowledge of accreditation standards, and consulting skillsUsually holds certifications in healthcare or quality management, with knowledge of NCQA standards
Work EnvironmentAdvises healthcare organizations, often working independently or in consulting firmsWorks within healthcare organizations or as part of a team to ensure compliance
Employer & Industry UsageConsulting firms, healthcare organizations seeking accreditationHospitals, clinics, or healthcare agencies preparing for NCQA accreditation

While Ncqa Accreditation Consulting involves providing expert advice to organizations aiming for NCQA accreditation, Ncqa Accreditation Specialists focus on implementing and maintaining compliance within healthcare facilities. Both roles require knowledge of NCQA standards, but consulting emphasizes strategic guidance, whereas specialists handle day-to-day compliance tasks.

How do you become NCQA accreditation consulting?

To become an NCQA accreditation consultant, professionals typically gain experience in healthcare quality management, understand NCQA standards, and obtain relevant certifications such as the NCQA Patient-Centered Medical Home Certification. Strong knowledge of healthcare regulations, data analysis skills, and familiarity with accreditation processes are essential for success in this role.
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Ncqa Accreditation Consulting jobs near you
Infographic showing various Ncqa Accreditation Consulting job openings in the United States as of August 2026, with employment types broken down into 2% As Needed, 91% Full Time, 2% Part Time, and 5% Contract. Highlights an 58% In-person, 11% Hybrid, and 31% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Delegation Oversight: Audit Coordinator

w3r Consulting

Chicago, IL • On-site

Contractor

Re-posted 19 days ago

Job description

Description:
This position is responsible for creating, managing and reporting processes designed to monitor and evaluate activities and functions delegated to contracted, delegated entities and vendors for assigned products and business lines according to all corporate and regulatory/accreditation requirements and standards.
Job Responsibilities:
  • Develop, implement and manage processes and systems to monitor and evaluate all statewide delegated activities to groups, IPAs and vendors for PPO, POS and HMO products.
  • Establish and maintain pre-delegated and delegated oversight documentation (policies, procedures, audit tools, reporting formats, communication materials and scheduling) that is consistent with the intent of regulatory/accreditation requirements.
  • Maintain relationships with contacts at delegated groups to assure complete, timely and accurate communication regarding delegated functions and responsibilities.
  • Coordinate with key internal areas (Legal, HMO Compliance, Network Management, UM/QI, Finance) to ensure accurate and timely communication regarding the status of delegated groups, appropriate delegated contractual terms and pertinent information is distributed regarding new/revised regulations.
  • Keep abreast of current regulatory/accreditation requirements (Texas Department of Insurance, NCQA, URAC, NAC).
  • Review and evaluate mandatory delegated oversight reporting and follow processes to ensure timelines are met and information is disseminated throughout the organization for analysis, identification of opportunities to improve and incorporation of action plans, ongoing monitoring or de-delegation procedures as appropriate.
  • Participate in the management of member and provider complaints and appeals to assure appropriate resolution within established timeframes.
  • Schedule, organize and perform annual and other periodic onsite audits at delegated entity locations.
  • Provide formalized delegated oversight reporting as scheduled to appropriate committees and departments to facilitate communication of delegated oversight results and coordinate corrective action plans.
  • Maintain manuals documenting oversight agreements, delineation of responsibilities, reporting, audit results and key communications for each delegate.
  • Represent the department and division in meetings, committees and internal and external presentations.

Required Job Qualifications:
  • Associate Degree in Business or Medical OR 3 or more years experience in a managed care environment.
  • 2 years in a leadership role that includes direct accountability and responsibility and direction of staff.
  • 2 years' experience in directly performing delegated oversight activities.
  • Project Management skills and experience.
  • Knowledge of regulatory/accreditation requirements and standards (TDI, NCQA, URAC).
  • Verbal and written communication skills.
  • Organizational skills and the ability to handle multiple priorities.
  • PC proficiency to include Word, Excel, PowerPoint and Lotus Notes.
  • Ability to travel (up to 30-40%) within Texas. Minimal travel outside of the state.

Preferred Job Qualifications:
  • Bachelor Degree in Business or Medical.
  • Knowledge of Power Point, Visio and Access.
  • College level courses or certification in project management.

Additional Responsibilities Required by All Client's Employees:
  • Act with integrity and maintain a respectful, professional manner in all interactions with co-workers, management, customers and other business contacts
  • Comply with HIPAA, the Code of Business Ethics & Conduct, our Diversity & Inclusion Principles, and other applicable corporate and departmental policies
  • Maintain complete confidentiality in all matters of company business
  • Maintain communication with management regarding developments within areas of assigned responsibilities, and perform special projects as required or requested.

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