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Remote Ncqa Jobs in Georgia (NOW HIRING)

Oscar Health

Director, Provider Operations

Atlanta, GA · Remote

$147K - $193K/yr

This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully ... Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act. * Prior ...

Oscar Health

Director, Provider Operations

Atlanta, GA · Remote

$147K - $193K/yr

This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully ... Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act. * Prior ...

Oscar Health

Director, Provider Operations

Atlanta, GA · Remote

$147K - $193K/yr

This is a remote position, open to candidates who reside in: Atlanta, Georgia. You will be fully ... Comprehensive knowledge of NCQA credentialing, CMS standards, and the No Surprises Act. * Prior ...

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Remote Ncqa information

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 are the key skills and qualifications needed to thrive as a Remote NCQA (National Committee for Quality Assurance) professional, and why are they important?

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 remote NCQA jobs?

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 some common challenges faced by professionals working remotely in NCQA-related 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 are the most commonly searched types of Ncqa jobs in Georgia? The most popular types of Ncqa jobs in Georgia are:
What are popular job titles related to Remote Ncqa jobs in Georgia? For Remote Ncqa jobs in Georgia, the most frequently searched job titles are:
What job categories do people searching Remote Ncqa jobs in Georgia look for? The top searched job categories for Remote Ncqa jobs in Georgia are:
What cities in Georgia are hiring for Remote Ncqa jobs? Cities in Georgia with the most Remote Ncqa job openings:
Remote Ncqa jobs near you
Physician / Cardiology / Georgia / Permanent / Associate Medical Director - Cardiology - 100% Remote

Physician / Cardiology / Georgia / Permanent / Associate Medical Director - Cardiology - 100% Remote

eviCore healthcare

Atlanta, GA • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 11 days ago

Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must have a minimum of 5 years clinical experience, beyond residency/fellowship Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is requiredNo nights, no weekends, not call.Predictable work scheduleFull and part time opportunitiesSalaried position with benefitsSupportive organization with collaborative cultureeviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:Flexible scheduling and work/life balance with remote and work from home opportunities4 weeks of PTO(starting) per year plus paid holidaysOne week of CMEEducation assistance, tuition reimbursement and professional certifications Health, dental, vision, and life benefits with employer funded HSAPaid Volunteer Community Service Days Ample opportunities for growth, advancement, and promotion 401k retirement plan with company match of 50% employee contributions up to 6% eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation

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