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Remote Ncqa Jobs in Virginia (NOW HIRING)

Sentara Health

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$10K/mo

Experience supporting an NCQA HEDIS compliance audit.(preferred) * Knowledge of ECDS, digital HEDIS ... For positions that are available as remote work, Sentara Health employs associates in the following ...

Sentara Healthcare

IT HEDIS & Analytics Manager

Norfolk, VA · On-site +1

$29.25 - $38.75/hr

Experience supporting an NCQA HEDIS compliance audit.(preferred) * Knowledge of ECDS, digital HEDIS ... For positions that are available as remote work, Sentara Health employs associates in the following ...

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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 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.
What are popular job titles related to Remote Ncqa jobs in Virginia? For Remote Ncqa jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Remote Ncqa jobs in Virginia look for? The top searched job categories for Remote Ncqa jobs in Virginia are:
What cities in Virginia are hiring for Remote Ncqa jobs? Cities in Virginia with the most Remote Ncqa job openings:
Remote Ncqa jobs near you

IT HEDIS & Analytics Manager

Sentara Health

Norfolk, VA • On-site, Remote

$10K/mo

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Sentara Health rating

6.8

Company rating: 6.8 out of 10

Based on 398 frontline employees who took The Breakroom Quiz

490th of 887 rated healthcare providers

Job description

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

OverviewThe IT HEDIS Manager is responsible for leading the technology, data integration, platform operations, and technical validation functions that support the organization’s HEDIS program. This role manages ETL developers and operational support staff while serving as a key IT partner to HEDIS, Quality, business, vendor, audit, and project stakeholders. The manager oversees HEDIS data feeds, production operations, platform support, data-quality controls, technical documentation, vendor coordination, audit support, and reporting deliverables. This role will also support a major HEDIS engine replacement initiative, including migration from the current Inovalon/Cotiviti environment to a future-state platform with Arcadia supporting portions of HEDIS and NCQA-related functionality. Education
  • Bachelor’s degree in Information Technology, Computer Science, Data Management, Healthcare Administration, or a related field (Preferred)
or
  • 7+ years relevant experience may be accepted in lieu of degree
Certification/Licensure
  • No specific certification or licensure requirements
Experience
  • Seven or more years of experience in healthcare data, payer technology, analytics, data warehousing, quality measurement, HEDIS operations, or related IT functions (required )
  • Three or more years of leadership experience managing ETL, data engineering, technical operations, analytics, production support, or similar teams, including direct oversight of staff (required)
  • Experience supporting HEDIS data processing, reporting, validation, audits, quality-measurement platforms, or HEDIS engine implementation, replacement, migration, or parallel-validation activities(Required)
  • Strong knowledge of payer enrollment, claims, encounters, pharmacy, provider, laboratory, clinical, supplemental data, ETL, SQL, data warehouses, Databricks, file-based integrations, APIs, testing, reconciliation, and production support.
  • Experience working with HEDIS-related vendors or platforms such as Arcadia, Cotiviti, Inovalon, or comparable systems, with the ability to communicate technical issues clearly to business, vendor, audit, project, and executive stakeholders.(preferred)
  • Experience supporting an NCQA HEDIS compliance audit.(preferred)
  • Knowledge of ECDS, digital HEDIS measures, FHIR, HIE integration, and clinical-data exchange

Keywords: LinkedIn , HEDIS, Cotiviti, Innovalan,Arcadia

Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave • Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000• Reimbursement for certifications and free access to complete CEUs and professional development•Pet Insurance 
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.


In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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