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Ncqa Jobs Near Me

Integrated Resources INC

Case Manager

Columbus, OH · On-site

$19.25 - $24.75/hr

Familiarity with NCQA standards, state/federal regulations and measurement techniques. In depth knowledge of CCA and/or other Case Management tools. Ability to take initiative and see tasks to ...

Integrated Resources INC

Case Manager

Columbus, OH · On-site

$19.25 - $24.75/hr

Familiarity with NCQA standards, state/federal regulations and measurement techniques. In depth knowledge of CCA and/or other Case Management tools. Ability to take initiative and see tasks to ...

Pwc

Payer Healthcare Data Scientist, Manager

Columbus, OH · On-site

$99K - $232K/yr

... NCQA HEDIS specifications and CMS Star Ratings - Knowledge of government payer programs and Medicaid - Experience with NLP or unstructured clinical text - Exposure to social determinants of health ...

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How much do ncqa jobs pay per year?

As of Aug 13, 2026, the average yearly pay for ncqa in the United States is $131,052.00, according to ZipRecruiter salary data. Most workers in this role earn between $121,000.00 and $138,000.00 per year, depending on experience, location, and employer.
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Ncqa jobs near you
A map of the United States highlighting the number of Ncqa job openings by state according to ZipRecruiter. The image is accompanied by a detailed chart listing the number of Ncqa job openings in each state, with California having the most at 2 and Alaska the least at 0.

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

Molina Healthcare

Columbus, OH • On-site, Remote

$54K - $107K/yr

Full-time

Re-posted 15 days ago

Molina Healthcare rating

8.0

Company rating: 8.0 out of 10

Based on 199 frontline employees who took The Breakroom Quiz

163rd of 306 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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