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Remote Ncqa Jobs in California (NOW HIRING)

LIBERTY DENTAL

Ensure applications are complete, accurate, and compliant with NCQA, URAC, state, federal, and ... This is a fully remote position, but candidates must reside in Oklahoma or Florida Healthcare or ...

Insperity

Director of Claims- Healthcare

Chatsworth, CA · On-site +1

$130K - $160K/yr

... CMS, NCQA, contractual, and health plan requirements, supporting TMS's commitment to service ... Paid time off, flexible schedule, and remote work one day per week Plus, we work to maintain the ...

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Remote Ncqa information

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.

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

The most popular types of Ncqa jobs in California are:

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

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

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

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

What cities in California are hiring for Remote Ncqa jobs?

Cities in California with the most Remote Ncqa job openings:

Remote Ncqa jobs near you

Preventative Care Advocate

San Bernardino, CA • On-site, Remote

LSMA Management Inc
See more jobs at LSMA Management Incexternal

$33.65 - $35.10/hr

Full-time

Posted 22 days ago

Job description

Description

JOB SUMMARY:

The Preventative Care Advocate supports Quality Improvement and Population Health initiatives within a Managed Services Organization (MSO) serving an Independent Practice Association (IPA) network. This role is responsible for promoting compliance with Healthcare Effectiveness Data and Information Set (HEDIS), CMS Star Ratings, NCQA accreditation standards, DMHC regulatory requirements, and contracted health plan quality programs.

The Preventative Care Advocate works directly with contracted provider offices to improve preventive care delivery, close care  gaps, and enhance clinical documentation and quality performance. This position serves as a liaison between the MSO, IPA providers, and health plan partners to facilitate quality improvement initiatives, support audit readiness, and improve overall patient outcomes and performance metrics.

Requirements

MINIMUM & PREFERRED QUALIFICATIONS:


Education/Training

Minimum: High school diploma or equivalent required.

Preferred: Associate's degree or higher in healthcare administration, public health, social services, or related field. Certification as a Medical Assistant.


Experience 

Minimum: At least two years of experience in healthcare operations, quality improvement, medical office operations, care coordination, or managed care environment.

Preferred: Experience supporting HEDIS, CMS Star Ratings, or NCQA quality programs. Experience working in an MSO, IPA, or managed care organization. Experience supporting Medicare Advantage, Medi-Cal, or commercial populations. Experience with medical record abstraction and quality reporting processes.


Certification(s)

Certified Professional in Healthcare Quality (CPHQ), Medical Assistant certification, or related healthcare certification preferred.

Skills, Knowledge & Abilities

  • Knowledge of HEDIS measures and preventive care quality standards preferred.
  • Understanding of NCQA, CMS, DMHC, and health plan quality program requirements preferred.
  • Knowledge of preventive care guidelines and population health principles.
  • Proficiency in Microsoft Office applications, including Excel and PowerPoint.
  • Ability to work with electronic health record systems and quality reporting tools.
  • Strong organizational and tracking skills.
  • Excellent verbal and written communication skills.
  • Ability to educate and engage provider offices and interdisciplinary teams.
  • Ability to establish and maintain effective working relationships.
  • Strong attention to detail and data accuracy.
  • Ability to manage multiple priorities and deadlines.
  • Ability to work independently and collaboratively.
  • Bilingual (Spanish or other threshold language) preferred.
  • Knowledge of managed care and IPA environments preferred.

PHYSICAL, MENTAL & ENVIRONMENTAL REQUIREMENTS:

The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. Primarily sedentary work involving prolonged computer use. Frequent standing, walking, and travel to provider offices may be required. Occasional lifting of up to 10 pounds may be necessary. Requires the ability to analyze performance data, maintain attention to detail, and communicate effectively. Work is performed in office, remote, and provider office environments, with frequent use of electronic systems and reporting tools.


PAY RANGE 

$33.65 - $35.10 / hourly 

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