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
1w
Save
Mark Applied
Hide
HEDIS Audit Quality Manager (State and NCQA)
Atlanta or Woodland Hills or Waukesha or Hanover or Indianapolis or Miami or Cincinnati or Grand Prairie or Chicago or Iselin or Lake Mary or Woburn or Mendota Heights
$99k-$163k/yr HybridFull Time
3+ YOEBA/BS in a health care field and minimum 3 years healthcare experience plus 3 years QA/QI experience or equivalent; strong knowledge of NCQA HEDIS audit guidelines, audit management, project planning, and data analysis.
20h
Save
Mark Applied
Hide
Data Analyst - Remote
Chicago or Atlanta or Minneapolis or Omaha or Dallas or Phoenix
$60k-$107k/yr RemoteFull Time
2+ YOE2+ years SQL and healthcare data experience, intermediate Microsoft Excel (PivotTables/dashboards), analytic and communication skills, HEDIS/NCQA knowledge preferred.
SQL, Microsoft Excel, PivotTables
5d
Save
Mark Applied
Hide
Appeals & Grievances Quality Auditor
Arkansas or Arizona or Florida or Georgia or Iowa or Illinois or Kansas or Kentucky or Michigan or Minnesota or Missouri or North Dakota or Nebraska or Oklahoma or South Dakota or Tennessee or Texas or Virginia or Wisconsin
$57k-$85k/yr RemoteFull Time
5+ YOEBachelor's degree or equivalent experience and 5 years directly in health plan appeals & grievances; strong audit, analytical, regulatory (CMS/NCQA) and quality improvement skills.
1w
Save
Mark Applied
Hide
Senior Regulatory Implementation and Assurance Analyst
Pennsylvania or Maryland or Washington or North Carolina or Louisiana or Kentucky or Kansas or Indiana or Illinois or Georgia or Iowa or Florida or Colorado or California or Delaware or Connecticut or Arkansas or Arizona or Alabama or Alaska or Nevada or Vermont or Tennessee or Idaho or Oklahoma or Hawaii or Mississippi or Utah or New Hampshire or New Mexico or Wyoming or North Dakota or South Dakota or Rhode Island or West Virginia or Missouri or Texas or District of Columbia or Ohio or New Jersey or Oregon or South Carolina or Virginia or Massachusetts or Nebraska or Minnesota or Michigan or Wisconsin or New York or Maine
$79k-$127k/yr HybridFull Time
5+ YOE5+ years interacting with regulators/auditors, bachelor’s degree or equivalent experience, knowledge of regulatory frameworks (HIPAA, NIST, PCI, CMS, NCQA), strong communication, analytics, and project leadership skills.
3w
Save
Mark Applied
Hide
Program Manager - Quality Improvement
Chicago, Illinois, United States
$67k-$79k/yr OnsiteFull Time
3+ YOEBachelor's in healthcare-related field required; 3+ years quality improvement experience and 2+ years primary/ambulatory care experience; project management, analytics, EHR experience; knowledge of HEDIS, CMS/UDS, NCQA.
EPIC EHR, Electronic Health Record (EHR)
3w
Save
Mark Applied
Hide
Sr. Manager Corporate Compliance-Special Needs Plans
Ohio or Irving or Scottsdale or Woonsocket or Hartford or Northbrook
$83k-$183k/yr HybridFull Time
7+ YOE2+ Mgmt7+ years Medicare/Medicaid compliance experience (SNP focus), 2+ years project management, knowledge of CMS/NCQA/regulations, audit and corrective action experience, strong analytical and communication skills, bachelor’s or equivalent.
Microsoft Office, Archer
1w
Save
Mark Applied
Hide
Provider Credentialing Rep
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$44k-$52k/yr RemoteFull Time
2+ YOEHigh school diploma/GED, 2+ years provider credentialing and provider data system experience, knowledge of URAC/NCQA and federal program requirements, U.S. citizenship and favorable DoD background investigation for TRICARE support.
Outlook, Teams, Word, Excel, PowerPoint, SharePoint
3w
Save
Mark Applied
Hide
RN Manager of Delegation Compliance
Illinois, United States
$88k-$190k/yr RemoteFull Time
5+ YOE2+ MgmtActive RN license, bachelor’s in nursing, 5+ years healthcare experience, 2+ years supervisory experience, CCM or equivalent (or obtain within 12 months), knowledge of Medicare/Medicaid and NCQA, strong communication and leadership skills.
Microsoft Office, Google Suite, healthcare EMRs
2d
Save
Mark Applied
Hide
Delegation Oversight Coordinator - Work From Home
Richardson or Helena or Albuquerque or Tulsa or Chicago or Nashville
$56k-$124k/yr RemoteFull Time
4+ YOE4+ MgmtBachelor's in business/medical or 4+ years managed care experience; 4 years leadership and 4 years performing delegated oversight; project management; knowledge of TDI, NCQA, URAC; Word/Excel/PowerPoint/Lotus Notes proficiency; <10% travel.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Lotus Notes, Visio
1mo
Save
Mark Applied
Hide
Coding Integrity & National Strategy Sr. Principal
Chicago or Washington
$192k-$264k/yr HybridFull Time
10+ YOE10+ years enterprise SaaS sales or business development with 5+ years selling into payer organizations; Bachelor’s required (MBA/MPH preferred); GTM, enterprise sales, payer operations, and compliance experience.
CMS, NCQA, HEDIS, HIPAA, PHI, PII, SOC2, HiTrust