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Remote Ncqa Jobs (NOW HIRING)

VIVA USA INC

Credentialing Specialist

TX · On-site +1

Fully remote Position Summary The Credentialing Specialist ensures clinicians successfully pass the ... Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA ...

Global Channel Management

Remote Coverage Review Pharmacist

$59.50 - $71.75/hr

About the job Remote Coverage Review Pharmacist Remote Coverage Review Pharmacist needs 3 years and ... Solid understanding of regulatory guidelines (FDA, NCQA, EQRO, CMS) required * Knowledge of medical ...

Centene

Quality Improvement Project Manager

$70K - $126K/yr

... remote role*** Position Purpose: Coordinate and monitor quality improvement and organizational projects from inception to closure including National Committee for Quality Assurance (NCQA) and Health ...

Phsorg

... NCQA, contractual and regulatory quality requirements and measures for all lines of business ... Remote: Open to applicants in the United States, excluding CA, IL, ND, NY, WA, and WY. Hybrid: For ...

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Remote Ncqa information

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$29K

$56.7K

$114.5K

How much do remote ncqa jobs pay per year?

As of Sep 2, 2026, the average yearly pay for remote ncqa in the United States is $56,684.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,000.00 and $61,000.00 per year, depending on experience, location, and employer.

What is a remote NCQA job?

Remote NCQA jobs are positions that involve working from home or another remote location to support the standards and accreditation processes of the National Committee for Quality Assurance (NCQA). These roles often include responsibilities such as quality assurance, healthcare compliance, auditing, and documentation review for healthcare organizations. Remote NCQA professionals may work as auditors, consultants, or quality analysts, helping ensure healthcare organizations meet NCQA standards for accreditation. These jobs require knowledge of NCQA guidelines and strong attention to detail, as well as experience in healthcare administration or quality improvement.

What skills and qualifications are needed to thrive as a remote NCQA professional?

To thrive as a Remote NCQA professional, you need a comprehensive understanding of healthcare quality standards, accreditation processes, and regulatory compliance, often supported by experience in healthcare administration or related certifications. Familiarity with NCQA guidelines, quality management software, and electronic health record (EHR) systems is typically required. Strong attention to detail, analytical thinking, and effective communication skills are crucial for success in remote environments. These skills ensure the accurate evaluation and implementation of quality standards, which are vital for maintaining accreditation and improving patient care outcomes.

What are common challenges faced by professionals working remotely in NCQA roles, and how can they be addressed?

Professionals working remotely in NCQA (National Committee for Quality Assurance) roles often face challenges such as coordinating effectively with cross-functional teams, managing detailed documentation, and staying up-to-date with evolving accreditation standards. To address these, it’s important to leverage collaboration tools, establish regular virtual meetings, and maintain organized digital records. Staying engaged with professional development opportunities and NCQA updates can also help remote team members remain effective and compliant.

What is the difference between Remote Ncqa vs Remote Medical Reviewer?

AspectRemote NcqaRemote Medical Reviewer
Required CredentialsMedical license, NCQA certificationMedical license, specialty-specific certifications
Work EnvironmentHome-based, administrative tasks, data reviewHome-based, clinical review of medical records
Industry UsageHealthcare quality organizations, insurance companiesInsurance companies, healthcare providers
Common Search/ComparisonRemote Ncqa vs Remote Medical Reviewer

Remote Ncqa and Remote Medical Reviewer roles both involve healthcare quality and review tasks, often working from home. While both require medical credentials, Remote Ncqa focuses on healthcare quality standards and accreditation, whereas Remote Medical Reviewers primarily evaluate medical records for insurance claims or clinical accuracy. Understanding these differences helps job seekers identify roles aligned with their certifications and career goals.

Is NCQA a good place to work?

Remote NCQA positions are generally considered stable with a focus on healthcare quality standards and data analysis. Employees often work in a collaborative environment, with opportunities for professional development and remote work flexibility. However, experiences can vary based on role and individual expectations.
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Remote Ncqa jobs near you
Infographic showing various Remote Ncqa job openings in the United States as of August 2026, with employment types broken down into 6% As Needed, 80% Full Time, 12% Part Time, and 2% Contract. Highlights an 73% Physical, 3% Hybrid, and 24% Remote job distribution, with an average salary of $56,684 per year, or $27.3 per hour.

Care Management Coordinator/RN - 100% Remote

Alpha Business Solutions

Remote

$42 - $46/hr

Other

Medical, Dental, Vision, Life

This job post has expired 2 days ago. Applications are no longer accepted.

Job description

Title: Care Management Coordinator/RN
Location: 100% Remote
Duration: 3+ Months (FT conversion)
Job Description
Candidates will be remote but need to reside in the tri-state area.
UM RN - PA License. **No LPN candidates.
QUALITY LETTER REVIEW
Title: Compliance Specialist
Job Summary
The Compliance Specialist role assures that staff performance is compliant with the various regulations and standards applying to Utilization Management operations. These regulations include, NCQA, CMS and multiple state requirements. In addition, the Compliance Specialist monitors the medical review process to assure that staff are making appropriate medical necessity determinations, applying InterQual and medical policy correctly, and making accurate and well-documented referrals to Medical Directors, and documenting correctly for letter generation. This position is responsible for coordinating business operations support for NCQA activities (survey, annual document preparation and maintenance) as well the various projects and initiatives.
Responsibilities
• ssesses regulations and standards (NCQA, CMS and State) and assures appropriate controls are in place, making recommendations and overseeing implementation of new controls where necessary
• Reports potential issues and trends monthly impacting efficiency and quality based on compliance audit findings to Managers and Director
• Performs ongoing sample case reviews to assure that staff are applying InterQual and medical and departmental policy guidelines correctly and referring appropriate cases to the Medical Director. Assures that information provided to the Medical Director is relevant and helpful in making determinations
• ssures that clinical staff are documenting appropriately in medical management system so that member letters are clear, understandable, and meet regulatory requirements
• cts as a resource for internal and external sources, utilizing excellent communication skills and responding in a timely and focused professional manner
• Other duties as assigned
Qualifications
• Minimum five (5) years clinical experience
• ctive PA Licensed Registered Nurse required
• Registered nurse, BSN Preferred
• Must have strong interpersonal skills with demonstrated ability to provide associate feedback and support while maintaining positive, productive interpersonal relationships
• Knowledge of utilization review processes and utilization management systems, moderate to strong knowledge of InterQual required
• Excellent verbal and written communication skills with a key focus on attention to detail
• Strong use of Excel, Power Point and Word
• Experience adhering to NCQA, CMS and other programs requiring regulatory compliance
• Strong problem-solving abilities, organizational and planning skills
Benefits:
We offer a competitive compensation package that includes:
• [Pay Rate]: $42 - $46 per Hour
o Note: Pay rate will be commensurate with experience.
• Medical for full time employees
• Dental, and Vision Insurance
• Life Insurance, Short-Term Disability, Long-Term Disability, etc.

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