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Remote Ncqa Accreditation Jobs in Oregon (NOW HIRING)

Jobs for Humanity

Quality Compliance Specialists

Salem, OR · Remote

$21.82 - $42.55/hr

Specialist, Quality Interventions/QI Compliance (Remote) Application Deadline: Open Until Filled ... NCQA accreditation surveys and federal/state QI compliance activities. Only candidates with ...

Healthcare Support Staffing

Remote HEDIS Specialist

OR · On-site +1

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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Remote Ncqa Accreditation information

What is remote NCQA accreditation?

Remote NCQA accreditation refers to the process of a healthcare organization obtaining accreditation from the National Committee for Quality Assurance (NCQA) without requiring in-person site visits. Instead, all reviews, documentation submissions, and interviews are conducted virtually using secure online platforms. This approach allows organizations to demonstrate their compliance with NCQA standards while reducing travel, increasing flexibility, and maintaining safety, especially important during public health concerns or for organizations in remote locations.

What are the key skills and qualifications needed to thrive as a remote NCQA Accreditation specialist?

To thrive as a Remote NCQA Accreditation Specialist, you need expertise in healthcare quality standards, regulatory compliance, and thorough knowledge of NCQA guidelines, typically supported by a healthcare-related degree and relevant work experience. Familiarity with accreditation management software, quality improvement tools, and electronic document management systems is essential. Strong analytical thinking, attention to detail, and effective written and verbal communication skills help ensure thorough documentation and collaboration with internal teams. These skills are crucial for maintaining compliance, achieving accreditation, and supporting continuous quality improvement in healthcare organizations.

What are some common challenges faced by professionals working remotely on NCQA accreditation projects?

Professionals working remotely on NCQA accreditation projects often encounter challenges such as coordinating documentation reviews across multiple teams, ensuring timely communication with stakeholders, and managing strict deadlines. Since much of the work relies on cross-functional collaboration, staying organized and using digital project management tools is essential. Additionally, understanding the evolving NCQA standards and maintaining compliance remotely can require proactive learning and regular virtual meetings to stay aligned with team goals.

What is the difference between Remote Ncqa Accreditation vs Remote Medical Coder?

AspectRemote Ncqa AccreditationRemote Medical Coder
CertificationsNCQA Accreditation, relevant healthcare quality certificationsCertified Coding Specialist (CCS), CPC, or equivalent
Work EnvironmentRemote, healthcare organizations, quality assurance teamsRemote, healthcare facilities, insurance companies
Industry UsageHealthcare quality improvement, compliance, accreditationMedical record coding, billing, reimbursement

Remote Ncqa Accreditation focuses on healthcare quality standards and accreditation processes, requiring knowledge of NCQA guidelines. Remote Medical Coders specialize in translating medical records into standardized codes for billing and reimbursement. While both roles are remote and healthcare-related, Ncqa Accreditation professionals focus on quality assurance, whereas Medical Coders handle coding tasks. Understanding these differences helps job seekers identify the right career path based on their skills and certifications.

What are the most commonly searched types of Ncqa Accreditation jobs in Oregon?

The most popular types of Ncqa Accreditation jobs in Oregon are:

What are popular job titles related to Remote Ncqa Accreditation jobs in Oregon?

For Remote Ncqa Accreditation jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching Remote Ncqa Accreditation jobs in Oregon look for?

The top searched job categories for Remote Ncqa Accreditation jobs in Oregon are:

Remote Ncqa Accreditation jobs near you

Provider Performance Specialist-Senior

Corvallis, OR • Remote

Samaritan Health Services

6.8

Company rating: 6.8 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

499th of 895 rated healthcare providers

People enjoy working here

Recommended by parents

Respectful managers

Learn more about Samaritan Health Servicesexternal

Full-time

Re-posted 25 days ago

Job description

  • This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
  •  
  • JOB SUMMARY/PURPOSE
    • Provides advanced leadership in provider performance management and network optimization. Manages strategic provider relationships, leads complex performance initiatives, and serves as a senior escalation resource supporting the Plan Performance provider operating model.
  • DEPARTMENT DESCRIPTION
    • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity
      Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan
      Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System,
      Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier
      Communities Together.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor’s degree in Healthcare Administration, Public Health, Health Informatics, or a related field, or equivalent related experience required.
    • Four (4) years of experience in a healthcare payer, integrated delivery system, ACO, or value-based care environment required.
    • Experience with the following tools required:
      • Excel (advanced).
      • Power BI/Tableau or similar visualization platforms.
    • Experience in the following preferred:
      • Population health or analytics platforms.
      • Designing or improving provider workflows, performance improvement initiatives, or cross functional operational processes.
      • Managed care leadership, with experience supporting D-SNP or dual-eligible populations.
      • Delegated UM, delegated credentialing, or managing leased network environments.
    • Lean Six Sigma or process improvement certification preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Healthplan and regulatory expertise, including working knowledge of Medicare Advantage program operations, Medicaid/CCO performance programs, CMS regulatory frameworks, NCQA accreditation and quality program expectations, delegated oversight model concepts, and provider network performance management
    • Strong analytical and executive communication skills. Ability to use data storytelling to influence physician behavior.
    • Ability to interpret healthcare performance data and translate into provider action.
    • Ability to analyze dashboards including HEDIS / STARs measures, Risk Adjustment (RAF/HCC) Performance, Access and Utilization Metrics, and Provider Experience Indicators.
    • Ability to identify performance drivers and root causes across clinical and operational workflows.
    • Working knowledge of Risk Adjustment methodology (HCC/RAF concepts), documentation and recapture workflows, annual visit/wellness visit operational models, and preventative chronic care quality improvement strategies.
  • PHYSICAL DEMANDS

    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      CLIMB - STAIRS

      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

      LIFT (Knee to chest: 24"-54") 0 – 20 Lbs

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

      BEND FORWARD at waist

      KNEEL (on knees)

      STAND

      WALK – LEVEL SURFACE

      ROTATE TRUNK Standing

      REACH - Upward

      PUSH (0 - 20 pounds force)

      PULL (0 - 20 pounds force)

      SIT

      CARRY 2-handed, 0 - 20 pounds

      ROTATE TRUNK Sitting

      REACH - Forward

      MANUAL DEXTERITY Hands/wrists

      FINGER DEXTERITY

      PINCH Fingers

      GRASP Hand/Fist

       

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