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Remote Ncqa Accreditation Jobs (NOW HIRING)

Anders

Senior Provider Enrollment Specialist

Tulsa, OK · On-site +1

... NCQA, URAC, and CMS accreditation standards, and providing mentorship and guidance to junior staff ... Promote a collaborative, high-performance culture in a fully remote or hybrid team environment.

Choctaw Global

Credentials Coordinator (Remote)

National Committee for Quality Control (NCQA), Joint Commission, Department of Defense (DoD ... DHA accreditation standards (e.g., National Practitioner Data Bank (NPDB) queries, sanction ...

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 ...

TEEMA Group

Medical Director - Pediatrics

Phoenix, AZ · Remote

$140 - $145/hr

Accreditation Knowledge: Strong familiarity with NCQA, HEDIS, Joint Commission, URAC, or related ... USA - Remote Compensation, Benefits & Perks * Hourly Rate: $140.00 - $145.00 per hour. * Perks:

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How much do remote ncqa accreditation jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for remote ncqa accreditation in the United States is $37.04, according to ZipRecruiter salary data. Most workers in this role earn between $34.13 and $41.35 per hour, depending on experience, location, and employer.

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 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 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.
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Remote Ncqa Accreditation jobs near you
Infographic showing various Remote Ncqa Accreditation job openings in the United States as of August 2026, with employment types broken down into 90% Full Time, 2% Part Time, and 8% Contract. Highlights an 100% Remote job distribution, with an average salary of $77,034 per year, or $37 per hour.

Quality Review Specialist (RN or LPN/LVN)

VIVA USA INC

Downers Grove, IL • On-site, Remote

Contractor

Posted 11 days ago

Job description

Work closely with Utilization Management (UM), Case Management (CM) and Customer Service (CS) to ensure appeal process meets established guidelines.
Adhere to accreditation and regulatory requirements to improve customer service and achieve organizational goals related to complaint and appeal resolution.
Manage individual inventory through appropriate workflow.
Facilitate final resolution of member and provider appeals.
Participate in department initiatives related to NCQA and URAC audits, DOI audits, revision project, audits, and correspondence revision projects.
Serve on workgroups.
Adhere to compliance with external regulatory and accreditation standards.
Facilitate access to appeal files by members or member designee under federal guidelines.
Provide data for required reporting. 10.Work directly with members and providers to resolve appeals.
Support other team members in appeal resolution and in fulfilling other department responsibilities.
Assist in maintaining working relationships across organizational lines.
Ensure our member/providers requirements are met at all times.
Communicate and interact effectively and professionally with co-workers, management, customers, etc.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business.
Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
JOB REQUIREMENTS:
Applicants must hold an active RN or LPN/LVN license in good standing.
Bachelor's Degree OR 4 years in health care experience.
5 years utilization management, appeals, claims and mainframe system experience.
Experience in health operations.
Experience with internal/external customer relations.
Knowledge of managed care processes.
Knowledge and familiarity of national accreditation standards, specifically NCQA and URAC standards.
Knowledge of state and federal health care and health operations regulations.
Organizational skills and ability to meet deadlines and manage multiple priorities.
Verbal and written communication skills to include interfacing with staff across organizational lines plus interfacing with members and providers.
PC proficiency to include Microsoft Word, Access, and Excel.
PREFERRED JOB REQUIREMENTS:
Appeals or Utilization management experience.
Notes:
Fully remote
This is a M-F shift 40 hours per week, with MANDATORY holiday and weekend rotations.
Holidays rotation scheduled 3-4 holidays per year and one weekend every 3rd weekend.
This is a contract role with the possibility of conversion to full-time based on business needs and performance
VIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

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