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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 ...

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 ...

Sage Dental

Credentialing Specialist

Boca Raton, FL · On-site +1

Overview Sage is looking for a Delegated Credentialing Specialist (Remote) to join our team! The ... Adhere to NCQA guidelines. * Audit Provider Licensure Files to NCQA guidelines. * Pull Monthly ...

Healthcare Support Staffing

Remote HEDIS Specialist

OR · Remote

Remote worker with ability to read and write in Spanish and medical records. Under the direction of ... Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state ...

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How much do remote ncqa jobs pay per year?

As of Aug 13, 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 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.

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 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 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.
More about Remote Ncqa jobs
What cities are hiring for Remote Ncqa jobs? Cities with the most Remote Ncqa job openings:
What are the most commonly searched types of Ncqa jobs? The most popular types of Ncqa jobs are:
What states have the most Remote Ncqa jobs? States with the most job openings for Remote Ncqa jobs include:
What job categories do people searching Remote Ncqa jobs look for? The top searched job categories for Remote Ncqa jobs are:
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, 82% Full Time, 9% Part Time, and 3% Contract. Highlights an 75% Physical, 3% Hybrid, and 22% Remote job distribution, with an average salary of $56,684 per year, or $27.3 per hour.

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

Alliance

Remote

$69K - $88K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 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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