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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
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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.
4w
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Quality Specialist (Hybrid)
Baltimore or Washington
$48k-$96k/yr HybridFull Time
3+ YOEBachelor's degree (or 4 additional years' experience), 3+ years professional experience, expertise with NCQA/HEDIS/CMS frameworks, member/provider engagement, data analysis, and Microsoft Office tools.
NCQA, HEDIS, CMS, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Microsoft Outlook
1mo
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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
1w
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Credentialing Supervisor
Fulton, Maryland, United States
$30-$38/hr OnsiteFull Time
3+ YOE3+ years credentialing experience with supervisory exposure; knowledge of NCQA/CMS/payer standards, CAQH, NPI/PECOS, state licenses, DEA, board certifications, and credentialing workflow.
CAQH, Microsoft Office, payer portals, credentialing software
1mo
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Principal Architect - Remote or Hybrid in MN and DC
Eden Prairie or Minneapolis or Washington or United States
$135k-$231k/yr RemoteFull Time
5+ YOEUndergraduate degree or equivalent experience, 5+ years in healthcare data architecture, expertise with FHIR/HL7/X12, HEDIS/NCQA quality needs, strong data modeling and cloud platform experience.
FHIR, HL7, X12, CCD/C-CDA, Epic, Cerner, Oracle Health, Snowflake, Databricks, Azure, GCP, dbt, Kafka, CQL
1w
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Quality Improvement Manager
Washington, District of Columbia, United States
$80k-$90k/yr OnsiteFull Time
3+ YOE3+ years quality improvement or behavioral/community health experience; bachelor's degree or equivalent required; master's preferred; experience with accreditation, NCQA standards, auditing; DC clinical licensure (LPC or LICSW) encouraged.
1mo
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Executive Director, Hospital Care Coordination
Washington, District of Columbia, United States
$225k-$281k/yr OnsiteFull Time
10+ YOE10+ Mgmt10+ years of progressive clinical or healthcare management experience; Bachelor's degree in nursing/health services/business/public health; knowledge of Medicare/Medicaid, NCQA, TJC; strong analytics, change management, and communication skills.
1mo
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Senior Quality Analyst (Hybrid)
Baltimore, Maryland, United States
$72k-$144k/yr HybridFull Time
5+ YOE5+ years professional experience; Bachelor's in a related field (or equivalent experience); expertise in population health measurement, NCQA/HEDIS/CAHPS activities; advanced analytics using SQL/Python/R; Microsoft Excel proficiency.
SQL, Python, R, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Microsoft Outlook
4w
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EEE QI - Credentialing Specialist-New Jersey Ave-DC
Washington, District of Columbia, United States
$60k-$69k/yr OnsiteFull Time
3+ YOEManage credentialing and re-credentialing processes, maintain provider files, perform audits, ensure regulatory compliance (HRSA, NCQA, Joint Commission), verify licensure/certifications; 3+ years credentialing experience; Bachelor's degree or equivalent.
OneApp Pro, CAQH
4w
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Clinical Support Supervisor (Hybrid)
Baltimore, Maryland, United States
$62k-$128k/yr HybridFull Time
3+ YOEBachelor's degree or equivalent experience, 3+ years related professional experience with leadership, proficiency in Microsoft Office and electronic medical records, knowledge of care coordination and regulatory standards (NCQA/HEDIS/CMS), strong communication and data analysis skills.
Microsoft Office, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Electronic Medical Record (EMR)
4w
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Senior Quality Analyst (Hybrid)
Baltimore, Maryland, United States
$72k-$144k/yr HybridFull Time
5+ YOE5+ years professional experience; Bachelor's in population health/public health/healthcare administration/economics/statistics/data science or equivalent; expertise in population health measurement, NCQA/HEDIS/CAHPS, advanced analytics (SQL, Python, R), and Microsoft Office.
SQL, Python, R, Microsoft Excel, Microsoft Word, Microsoft PowerPoint, Microsoft Outlook
1w
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Director Case Management
Columbia, Maryland, United States
$121k-$238k/yr OnsiteFull Time
8+ YOE5+ MgmtBachelor's required, Master's preferred. 8+ years managed care experience, 5+ years leadership in case management. Requires RN or LCSW or other licensed clinician eligibility and CCM certification. Experience with Medicaid, CMS, NCQA, risk stratification and data-driven care models.
care management platforms, electronic health records, reporting tools
1mo
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Sr Applications Project Specialist- Epic Healthy Planet Certified- Kelsey-Seybold Clinic - Pearland Texas - Remote
Pearland or Minneapolis or Washington or United States
$92k-$164k/yr RemoteFull Time
4+ YOE4+ years systems experience in healthcare or business operations; Epic Healthy Planet certification (or attain within 12 months); strong clinical vocabulary knowledge (LOINC, ICD, CPT); project management, reporting, and stakeholder communication skills; valid Texas driver's license; occasional travel.
Healthy Planet, Epic, Compass Rose, MyPanel, Campaigns, HEDIS, LOINC, ICD, CPT, NCQA
1mo
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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
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