1mo
Save
Mark Applied
Hide
NCQA Specialist, Michigan
Flint, Michigan, United States
OnsiteFull Time
4+ YOEAssociate degree in healthcare or equivalent; 4 years' experience in government regulated health or managed care (with 2 years performing complex quality management including HEDIS/NCQA); Bachelors preferred; experience with quantitative/qualitative analysis and NCQA/HEDIS knowledge.
2mo
Save
Mark Applied
Hide
NCQA Specialist, Michigan in Michigan, Flint
Flint, Michigan, United States
OnsiteFull Time
4+ YOEAssociate degree in a health care field; four years in health organization or managed care; experience with quality management (HEDIS/NCQA); bachelor’s preferred; NCQA knowledge preferred.
HEDIS, NCQA standards, Quality Improvement
3mo
Save
Mark Applied
Hide
Quality Improvement Specialist NCQA - Denver Health Medical Plan (* Weekly Hybrid Schedule Requirement *)
Denver, Colorado, United States
$79k-$123k/yr HybridFull Time
4+ YOE4–6 years in health plan quality improvement with HEDIS/Stars; NCQA accreditation readiness; strong data analysis; Bachelor's in Public Health or related field; CPHQ and Green Belt certifications preferred.
Excel, Tableau, SAS
2mo
Save
Mark Applied
Hide
NCQA Quality Manager (Hybrid)
Baltimore, Maryland, United States
$108k-$200k/yr HybridFull Time
5+ YOE1+ MgmtExperience managing NCQA accreditation in health plans; 5 yrs healthcare/quality analytics; 1+ yr supervisory; Bachelor's or equivalent; SQL/Python/R; Excel.
SQL, Python, R, Microsoft Excel
1w
Save
Mark Applied
Hide
NCQA Quality - Accreditation Consultant Sr.
Seven Fields, Pennsylvania, United States
HybridFull Time
3+ YOEBA/BS in a health care field and minimum 3 years healthcare-related experience plus 2 years QA/QI experience (or equivalent combination). NCQA and URAC experience preferred.
3mo
Save
Mark Applied
Hide
Credential Analyst-NCQA, URAC and CMS
Lombard or Southfield or Richardson
$38k-$80k/yr HybridFull Time
2+ YOEBachelor degree or 6 years accreditation experience; knowledge NCQA/URAC/CMS; strong data, analytical, MS Office.
Microsoft Office, Excel, Email, Internet
1d
Save
Mark Applied
Hide
NCQA Quality & Accreditation Specialist (Full Time, Remote, North Carolina Based)
Morrisville, North Carolina, United States
$70k-$89k/yr RemoteFull Time
3+ YOEBachelor's in a related field and 3 years project management experience in managed care; knowledge of NCQA standards, regulatory compliance, strong communication, project management, and Microsoft Office skills.
Microsoft Project, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
3mo
Save
Mark Applied
Hide
Utilization Management Nurse
United States
RemoteFull Time
Active nursing license in good standing; prior authorization and UM expert; NCQA and InterQual experience preferred; Facets experience preferred.
NCQA, InterQual, Facets
1w
Save
Mark Applied
Hide
Utilization Management Nurse, LVN/LPN
California, United States
$26-$40/hr OnsiteFull Time
2+ YOEActive LVN/LPN license, 2+ years medical management experience, knowledge of MCG/InterQual/NCQA, CMCN preferred, Associate's in Nursing preferred.
MCG, InterQual, NCQA
19h
Save
Mark Applied
Hide
Clinical Quality Consultant
Newton, Massachusetts, United States
$92k-$164k/yr HybridFull Time
5+ YOE5+ years leading quality improvement and data analysis in managed care or provider settings; experience with HEDIS, NCQA, Star Ratings; intermediate Microsoft Office; commitment to health equity.
Microsoft Outlook, Microsoft Word, Microsoft PowerPoint, Microsoft Excel, HEDIS, NCQA, CAHPS, CMS Star Ratings
2w
Save
Mark Applied
Hide
AAPC/AHIMA Certified Professional Coder
Eden Prairie, Minnesota, United States
$100k-$120k/yr OnsiteFull Time
6+ YOEAAPC or AHIMA certification required; 6+ years experience in HEDIS measure QA, chart review, NCQA interpretation, and medical coding (ICD-10/CPT/HCPCS); strong analytical and communication skills.
HEDIS, NCQA, ICD-10, CPT, HCPCS
4w
Save
Mark Applied
Hide
Director, Utilization Management & Operational Integrity
Brooklyn, Ohio, United States
HybridFull Time
8+ YOE5+ MgmtBScN required (Master's preferred). Requires RN license, 8+ years progressive utilization management experience with 5+ years in leadership, NCQA/CMS/HIPAA knowledge, Microsoft Office proficiency, and strong communication and process-improvement skills.
NCQA, CMS, HIPAA, EMR, Microsoft Office, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, ICD-10, CPT, HCPCS
1mo
Save
Mark Applied
Hide
Strategic Provider Partnerships Manager (Value-Based Care) (669676)
Hanover, Maryland, United States
$45-$72/hr RemoteFull Time
5+ YOE5+ years healthcare/managed care experience with provider ambulatory care required; experience in population health, quality improvement, care management preferred; NCQA/HEDIS training preferred; ability to translate performance data and collaborate with clinical and operational leaders.
NCQA, HEDIS
4w
Save
Mark Applied
Hide
Medical Director
Boston or Massachusetts or New Hampshire
$173k-$250k/yr RemoteFull Time
8+ YOEMD/DO with active/unrestricted MA and NH licensure (or ability to obtain), 8+ years related experience (min 5 clinical, min 3 in medical management), board certification, knowledge of InterQual, NCQA, HEDIS, Medicare/Medicaid, strong communication and leadership.
InterQual, NCQA, HEDIS, E-Verify
1mo
Save
Mark Applied
Hide
Medical Director Medicaid
Pennsylvania or United States
RemoteFull Time
5+ YOE3+ MgmtMD/DO with active PA licensure (or ability to obtain within 6 months), 5+ years clinical experience, 3+ years health-plan medical leadership in Medicaid, experience with utilization management, appeals, medical policy, and familiarity with NCQA/URAC and Medicaid regulations.
InterQual, MCG, NCQA, URAC, HEDIS
2mo
Save
Mark Applied
Hide
Optometrist - Float
Saint Louis Park or Minneapolis or Brooklyn Center or Golden Valley or Maple Grove or Chanhassen or Shakopee or Burnsville or Bloomington or Lakeville
$137k-$205k/yr OnsiteFull Time
2+ YOEDoctor of Optometry with 2+ years of optometric experience; Minnesota licensure; NCQA credentialing.
Phoropter, Retinoscope, Ophthalmoscope, Slit Lamp, Keratometry, Lensometer, Radioscope, Trial Lenses, Indirect Ophthalmoscope, Fusion Test, Color Blindness Test, Applanation Tonometer
3mo
Save
Mark Applied
Hide
Process Improvement Project Manager
San Jose, California, United States
OnsiteFull Time
2+ YOELead medium to large quality/process improvement projects; collaborate with stakeholders; NCQA accreditation readiness.
Word, Excel, PowerPoint, Visio, Project, Outlook
2mo
Save
Mark Applied
Hide
Supervisor Appeals in Philadelphia, Pennsylvania
Philadelphia, Pennsylvania, United States
OnsiteFull Time
3+ YOE1+ MgmtLeadership of administrative appeals team; NCQA/state compliance; PA Act 146 knowledge; vendor and cross‑department collaboration.
1mo
Save
Mark Applied
Hide
Director, Quality & Process Improvement, HEDIS Audit
United States
$118k-$219k/yr RemoteFull Time
6+ YOEBachelor's degree; 6+ years quality and process improvement experience in healthcare; NCQA HEDIS/URAC/JCAO knowledge preferred.
2mo
Save
Mark Applied
Hide
NATIVE Youth Council (NYC) Program Coordinator
Spokane, Washington, United States
$30/hr HybridFull Time
Coordinate youth council program, recruit youth, manage records, coordinate activities and partnerships, ensure GPRA/UDS/NCQA compliance.
Microsoft Office
Explore Jobs