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Ncqa Jobs (NOW HIRING)

Strive Health

Sr. Manager, Quality & Delegation

Denver, CO · On-site

$108K - $136K/yr

Serve as clinical lead on delegation audits and NCQA CM and PHP accreditation chart readiness (including file preparation, mock audits, gap closure, ongoing monitoring and compliance). * Synthesize ...

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Independence Blue Cross

Supervisor Appeals

Philadelphia, PA · On-site

$22.25 - $27.50/hr

Educates staff on new or updated procedures, NCQA and state rule changes, and internal process improvements; monitors adoption of procedures to ensure consistency and accuracy. * Coaches, develops ...

Jobgether

Credentialing Coordinator

You will also monitor expiring credentials, track applications, and ensure compliance with NCQA and CMS standards. This is a detail-driven, administrative role where precision, organization, and ...

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How much do ncqa jobs pay per year?

As of Jul 3, 2026, the average yearly pay for ncqa in the United States is $131,052.00, according to ZipRecruiter salary data. Most workers in this role earn between $121,000.00 and $138,000.00 per year, depending on experience, location, and employer.

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

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.

How do you become NCQA certified?

To become NCQA certified, organizations must meet specific standards by submitting an application, undergoing a comprehensive review process, and demonstrating compliance through documentation and on-site assessments. The process often involves staff training, data collection, and continuous quality improvement efforts.

Is NCQA a good place to work?

NCQA offers roles related to healthcare quality measurement and accreditation, often requiring strong analytical skills and attention to detail. Employees report a professional environment with opportunities for growth, though experiences can vary based on position and department.

What does the NCQA do?

The NCQA (National Committee for Quality Assurance) is an organization that develops standards and measures to evaluate the quality of healthcare organizations and providers. Jobs related to NCQA often involve assessing compliance, data analysis, and quality improvement initiatives within healthcare settings.

What are some common responsibilities for professionals working in NCQA roles within healthcare organizations?

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 job?

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.

How much does a NCQA VP make?

A Vice President (VP) at NCQA typically earns between $150,000 and $250,000 annually, depending on experience, location, and responsibilities. Compensation may also include bonuses and benefits, with senior roles requiring strong leadership and healthcare quality expertise.
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Ncqa jobs near you
Infographic showing various Ncqa job openings in the United States as of June 2026, with employment types broken down into 3% As Needed, 87% Full Time, 8% Part Time, and 2% Contract. Highlights an 75% Physical, 2% Hybrid, and 23% Remote job distribution, with an average salary of $131,052 per year, or $63 per hour.
Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement)

Denver Health

Denver, CO • On-site

$31.25 - $41.25/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 14 days ago

Denver Health rating

7.9

Company rating: 7.9 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

151st of 1,004 rated hospitals

Job description

We are recruiting for a mission-driven Manager, HEDIS - Denver Health Medical Plan (Must Live in Colorado. Weekly On-Site Requirement) to join our team!
We're with you for life's journey. At Denver Health, purpose isn't just something we believe in-it's something we live every day, for life's journey.
Our Values
Respect | Belonging | Accountability | Transparency
Department
Managed Care Administration
* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Job Summary
Under minimal supervision, the HEDIS manager will oversee the Health Employer Data Information Set (HEDIS), and HOS survey project timelines; collaborates with vendors and internal IT department to ensure all data requirements and submissions are accurate and timely. Supports Population Health and QI teams with metric data and strategy for MCR Stars, Medicaid MLR and NCQA certification. Promotes positive interpersonal (customer) relationships with fellow employees, physicians, patients and visitors. Supervises RN, Medical Records HEDIS personnel.
Essential Functions:
• Data Project Management: Oversees the HEDIS/ HOS data collection, development and analysis; maintains and updates appropriate data collection systems and enters information, as required, using MS Office, and Managed Care systems used to extract data for HEDIS/ HOS while driving and providing oversight of post-audit reviews to define operational improvements for future HEDIS cycles. Ensures compliance with all NCQA HEDIS Audit requirements. (15%)
  • Support strategic goals of MCR Stars by providing subject matter expertise on quality metrics and HEDIS strategy (15%)
  • Support NCQA accreditation process by providing subject matter expertise on quality standards (10%)
  • Work with providers on appropriate coding and documentation for HEDIS Stars and MLR measures. Oversee post-audit reviews to define operational improvements for future HEDIS cycles. (10%)
  • Process and Procedure: Determines work procedures and expedites workflow; assigns duties and reviews work; prepares necessary and required reports to management. Delegates responsibility/authority. Identifies problems and opportunities for improvement; identifies appropriate solution and involves others in the implementation process. Makes recommendations for cost efficiency and process improvement. Meets all NCQA HEDIS Medical Record Review (MRR) requirements and deadlines. (10%)
  • Reporting and Analysis Prepares and/or reviews daily, weekly, monthly and quarterly quality assessment reports and conducts/reports findings for QI data for all lines of business as required for HEDIS/ HOS activities, lead discussions about data/results, provides timely updates. Meets NCQA Compliance Audit activities to include annual training/testing of HEDIS staff and timely completion of Supplemental Data Audit (SD), Medical Record Review Validation (MRRV, Inter-Rater Reliability (IRR) tracking, and supports HEDIS annual roadmap submission. (10%)
  • Vendor Management: Partners with vendors and manages tracking progress during and prior to submission such as HEDIS auditor and Hedis Data vendor for medical record capture (10%)
  • Staff Management: Creates annual HEDIS training and testing materials per NCQA Technical Specification and compliance audit requirements. Identifies training and staff development needs of employees, recognizes positive behavior and contributions to the staff, using praise, appreciation and rewards, participates in the selection of QI staff, sets performance expectations by developing job specific customer service expectations and behaviors. Promotes guidance/oversight of certain tasks and delegates appropriately. (10%)
  • Oversee post-audit reviews to define operational improvements for future HEDIS cycles. (10%)

Education:
  • Bachelor's degree In nursing, health informatics, healthcare administration, public health or related field required

Work Experience:
  • 4-6 years Project Management experience, preferably in HEDIS/HOS within a managed care environment required and
  • 4-6 years previous experience in performing medical record review, inter rater reliability and working knowledge of medical terminology and NCQA HEDIS Technical Specifications required and
  • 4-6 years previous experience with HEDIS quality measurements for health plan STAR ratings and
  • 4-6 years previous experience in healthcare, quality improvement, statistics and/or evaluation.

Licenses:
Knowledge, Skills and Abilities:
  • Prerequisite skills including collecting, compiling and interpreting HEDIS CAHPS , and HOS data for QI studies
  • Extensive knowledge of MCR Stars program and NCQA accreditation process including previous experience with HEDIS quality measurements, health plan STAR ratings and quality reporting
  • Knowledge/familiarity with medical terminology, medical record review, NCQA HEDIS Technical specifications, and decision making skills regarding appropriateness of care review.
  • Provide HEDIS /HOS data for research design planning and analysis to generate quality improvement reports.
  • Applies efficient research and data collection skills and organize information by line of business succinctly
  • Ability to work independently as well as collaboratively with other internal and external team members to ensure timelines are met
  • Utilizes software applications and information systems to perform work processes with responsibility for training on such and providing updates as necessary
  • Demonstrated leadership skills in working with clinical professionals and office staff
  • Ability to coach and lead others on a collaborative basis to ensure team success
  • Ability to engage physicians, advance care providers, vendors, clinical leaders, and other key stakeholders to deliver member-centered care.
  • Demonstrate flexibility in response to unexpected changes.

* Must Live in Colorado
*This is a hybrid role located in Denver, Colorado with a requirement of being in the office 3 days per week.
Shift
Days (United States of America)
Work Type
Regular
Salary
$98,600.00 - $152,800.00 / yr
Benefits
At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future - with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development - while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you're joining a mission-driven organization that invests in you.
Here is a small list of our benefit programs:
  • Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
  • 100% paid parental leave up to 6 weeks
  • Immediate eligibility for retirement plans with employer contribution up to 9.5%
  • Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
  • Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
  • Free RTD EcoPass (public transportation)
  • Childcare discount programs & exclusive perks on large brands, travel, and more
  • Tuition reimbursement & assistance
  • Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
  • Professional clinical advancement program & shared governance
  • Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
  • National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.
As Colorado's primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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