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Remote Ncqa 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.

BMC HealthNet Plan

Medical Director

Boston, MA · On-site +1

$173K - $250K/yr

Our Investment in You: • Full-time remote work • Competitive salaries • Excellent benefits ... and NCQA requirements • Conducts review of prior authorizations, concurrent reviews and ...

WellSense Health Plan

Medical Director

MA · On-site +1

$173K - $250K/yr

Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key ... and NCQA requirements · Conducts review of prior authorizations, concurrent reviews and ...

USM

JB061757 - HEDIS Data Analyst (SQL)

Philadelphia, PA · On-site +1

Philadelphia ,PA - Hybrid - 3 Days a week in the office/ Remote Duration: Long-Term Contract Job ... Familiarity with NCQA HEDIS specifications and reporting guidelines. * Experience with healthcare ...

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How much do remote ncqa jobs pay per year?

As of Jul 24, 2026, the average yearly pay for remote ncqa in the United States is $56,684.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,000.00 and $61,000.00 per year, depending on experience, location, and employer.

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.
More about Remote Ncqa jobs
What cities are hiring for Remote Ncqa jobs? Cities with the most Remote Ncqa job openings:
What are the most commonly searched types of Ncqa jobs? The most popular types of Ncqa jobs are:
What states have the most Remote Ncqa jobs? States with the most job openings for Remote Ncqa jobs include:
What job categories do people searching Remote Ncqa jobs look for? The top searched job categories for Remote Ncqa jobs are:
Remote Ncqa jobs near you
Infographic showing various Remote Ncqa job openings in the United States as of July 2026, with employment types broken down into 6% Locum Tenens, 12% Internship, 2% As Needed, 66% Full Time, 4% Part Time, and 10% Nights. Highlights an 75% Physical, 3% Hybrid, and 22% Remote job distribution, with an average salary of $56,684 per year, or $27.3 per hour.
Sr Quality Improvement, HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Sr Quality Improvement, HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Molina Healthcare

Long Beach, CA • On-site, Remote

$54K - $107K/yr

Full-time

Posted 25 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 196 frontline employees who took The Breakroom Quiz

147th of 281 rated insurance

Job description


Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team.
This role is remote however candidates must live in Ohio.
This role is laser focused on Quality Improvement using QI Science. This role will be assigned a primary population stream and will be expected to support improvement work for Medicare Stars Measures.
Highly qualified candidates will have the following experience-
  • Using the specific models for improvement required by the state of Ohio
  • Experience with a formal model like IHI or Lean or Six Sigma, Green or Yellow Belt Improvement
  • Power BI is helpful but expert level is not required
  • Familiarity with Medicare (Ideally the Duals population)
  • Familiarity with QI Science, Health Equity, Population Health, Health Management

This role also provides senior level support for clinical quality member intervention activities. Responsible for the developing and implementing new and existing member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid, etc.). Executes health plan member and community quality-focused interventions and programs in accordance with established program standards, and federal/state/National Committee for Quality Assurance (NCQA) regulations. Conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes.
Essential Job Duties
  • Implements evidence-based and data-informed key member intervention strategies including initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state quality initiatives.
  • Monitors and ensures that key member intervention activities are completed on time and accurately, and presents results to key departmental management and other applicable Molina departments.
  • Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of department interventions.
  • Creates, manages, and/or compiles required documentation necessary to maintain critical program milestones, deadlines, and deliverables.
  • Participates in quality improvement (QI) activities, meetings, and discussions with and between other departments within the organization.
  • Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations (CBOs).
  • Evaluates quality project/program activities and results to identify opportunities for improvement.
  • Raises gaps in processes that may require remediation to quality leadership.
  • Provides support for quality-related projects.
  • Provides training and support to new and existing quality member interventions team members.
  • Demonstrates flexibility when it comes to change management and maintains a positive outlook.
  • This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
  • This position may require multi-day overnight travel on occasion, depending upon state-specific needs.

Required Qualifications
  • At least 3 years of experience in health care, and at least 2 years of experience in health plan quality member interventions in a managed care setting, or equivalent combination of relevant education and experience.
  • Demonstrated solid business writing experience.
  • Proficiency with data analysis, manipulation and interpretation.
  • Intermediate knowledge and understanding of HEDIS and NCQA.
  • Critical-thinking, problem-solving and analytical skills.
  • Attention to detail and organizational skills.
  • Ability to navigate change with flexibility and a positive outlook.
  • Ability to work independently in a fast-paced, deadline-driven environment.
  • Effective verbal and written communication skills.
  • Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications
  • Experience with data reporting, analysis, and interpretation.
  • Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.
  • Certified Professional in Health Quality (CPHQ).
  • Certified HEDIS Compliance Auditor (CHCA).
  • Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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About Molina Healthcare

Sourced by ZipRecruiter

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Long Beach, CA, US

Year founded

1980

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