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Ncqa Jobs in Raleigh, NC (NOW HIRING)

Integrated Resources INC

HEDIS Nurse

Durham, NC

$29.25 - $38.75/hr

Knowledge with NCQA. Qualifications Prefer RN but would consider LPN. Additional Information Kind Regards, Kavita Kumari Delivery Lead Integrated Resources , Inc. IT Life Sciences Allied Healthcare ...

Labcorp

Program Operations Manager

Durham, NC · On-site

HEDIS, Stars, NCQA, CMS, TCPA). * Lead cross-functional projects focused on optimizing operational performance and client outcomes. Act as a key operational stakeholder in pilots and new product ...

Labcorp

Program Operations Manager

Durham, NC · Hybrid

HEDIS, Stars, NCQA, CMS, TCPA). * Lead cross-functional projects focused on optimizing operational performance and client outcomes. Act as a key operational stakeholder in pilots and new product ...

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Ncqa information

What skills and qualifications are needed for an NCQA position?

To thrive in an NCQA (National Committee for Quality Assurance) role, candidates typically need a strong background in healthcare quality assurance, data analysis, and knowledge of accreditation standards, often supported by a degree in healthcare administration or a related field. Familiarity with quality measurement tools, reporting systems like HEDIS, and NCQA accreditation processes or certifications is highly valued. Strong attention to detail, organizational skills, and the ability to communicate effectively with multidisciplinary teams set exceptional candidates apart. These skills are essential to ensure compliance, improve care quality, and navigate the complex requirements of healthcare accreditation.

Is NCQA a good place to work?

NCQA (National Committee for Quality Assurance) is a reputable organization known for its focus on healthcare quality standards. Employees often cite a professional work environment, opportunities for growth, and the importance of certifications and compliance in their roles. As with any organization, individual experiences may vary based on position and department.

What are the common responsibilities of an NCQA professional?

Professionals in NCQA roles are typically responsible for overseeing compliance with accreditation standards, conducting audits and quality assessments, and preparing documentation for NCQA reviews. They often collaborate with clinical and administrative staff to implement process improvements and ensure data accuracy in quality reporting systems such as HEDIS. Regular responsibilities may also include training teams on best practices, staying updated on changing quality standards, and leading initiatives to drive higher healthcare quality outcomes. This position offers meaningful opportunities to impact patient care and opens pathways to advanced roles in healthcare quality management.

What is an NCQA?

An NCQA job typically involves working with healthcare organizations to ensure compliance with the National Committee for Quality Assurance (NCQA) standards. Professionals in these roles help organizations achieve accreditation or certification by implementing quality improvement processes, conducting audits, and analyzing data. Common NCQA-related positions include quality assurance specialists, accreditation consultants, and analysts who focus on managed care, population health, and performance measurement. These roles require knowledge of NCQA guidelines, healthcare regulations, and data analysis to support quality improvement initiatives.

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Ncqa jobs near you
Infographic showing various Ncqa job openings in Raleigh, NC as of July 2026, with employment types broken down into 3% As Needed, 88% Full Time, 7% Part Time, and 2% Contract. Highlights an 78% Physical, 3% Hybrid, and 19% Remote job distribution.

NCQA Quality & Accreditation Specialist (Full Time, Remote, North Carolina Based)

Alliance

Morrisville, NC • On-site, Remote

$69K - $88K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

The NCQA Quality & Accreditation Specialist serves as the project management lead and subject matter expert for assigned NCQA standard areas and manages the assessment of related business functions for corresponding departments within the scope of NCQA standards (e.g. Provider and Member Services, Utilization Management, Population Health, Care Management, Provider Network, Member and Provider Communications, Delegation Oversight) to support high-quality performance and ensure successful NCQA Accreditation process.
This position is fulltime remote. While there is no expectation of being in the office routinely, they may be required to report to the Alliance Home Office (Morrisville, North Carolina) for business meetings as needed.
Responsibilities & Duties
Implement and Monitor Accreditation Workplan
  • Project management lead for assigned NCQA standard categories within the organization's QI workplan to achieve and maintain Health Plan Accreditation with LTSS distinction and any additional accreditations Alliance Health pursues
  • Identify gaps and risks and provide regular status reports from NCQA tracker to leadership
  • Serve as lead for NCQA Accreditation reviews for assigned standard categories by gathering all necessary documents and information from business areas, managing timely document submissions to NCQA, facilitating NCQA requests for additional information, and coordinating onsite review activities
  • Review and update policies and procedures, reports, materials, and files for completeness, accuracy, and compliance with NCQA Standards
  • Maintain calendar of documentation due dates, ongoing collection and tagging relevant policies/procedures, reports, materials, and files as appropriate
  • Participate in Delegation Oversight and audits as appropriate

Drive Organizational Accreditation Efforts
  • Provide technical support and education to staff regarding NCQA Health Plan Accreditation and LTSS Distinction Standards and supporting documentation
  • Assess business area functions against current and upcoming NCQA standards and identify potential performance gaps and associated risks and update NCQA tracker upon release of new/updated standards
  • Serve as the accreditation subject matter expert within organizational wide, cross-functional, and multi-disciplinary teams to bring each business area to a state of readiness
  • Identify and facilitate business area process improvements via means such as policies, workflows, and processes; follow-up to ensure improved outcomes
  • Coordinate and collaborate with cross-departmental teams to identify and implement organization-wide strategic initiatives that support quality performance
  • Communicate reporting due dates and reminders to business leads and leadership as appropriate
  • Maintain clear status updates regarding NCQA Readiness on NCQA Tracker, communicating risks as appropriate

Minimum Requirements
Education & Experience
Required:
Bachelor's degree in Healthcare, Human Services, Public Health Administration, Nursing, Business, or related field and three (3) years of project management experience in a managed care or healthcare setting with knowledge and practical experience health care quality or NCQA Health Plan accreditation processes and requirements.
Preferred:
Experience with NCQA Accreditation standards.
Knowledge of regulatory reporting, compliance requirements, and auditing procedures.
Project management.
Knowledge, Skills, & Abilities
  • Knowledge of NCQA accreditation processes and standards
  • Knowledge and understanding of federal and state regulations
  • Planning, project management and organizational skills
  • Excellent communication skills (written and verbal).
  • Interpersonal skills which are effective, respectful, and sensitive to a diverse and multicultural population of children, families, and co-workers,
  • Problem-solving, mediation, and conflict resolution skills
  • Teamwork and collaboration skills
  • Microsoft Project, Excel, Word (Edits and Tracking), and PowerPoint skills
  • Facilitation skills
  • Ability to work in a fast-paced environment with frequent interruptions
  • Ability to work under minimal supervision

Salary Range
$69,592 - $88,729/ Annual
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity
An excellent fringe benefit package accompanies the salary, which includes:
    • Medical, Dental, Vision, Life, Long Term Disability
    • Generous retirement savings plan
    • Flexible work schedules including hybrid/remote options
    • Paid time off including vacation, sick leave, holiday, management leave
    • Dress flexibility

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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