ncqa

Sage Dental Management is seeking a Delegated Credentialing Specialist (Remote) to organize, verify, and manage delegated credentialing for General and Specialty Dentists. The role requires adherence to NCQA guidelines, accurate file maintenance, and collaboration with internal departments. Ideal candidates have 2–3 years in healthcare credentialing...

Zing Health, Inc. is seeking a detail-oriented Pharmacy Quality Assurance Analyst to ensure Pharmacy Operations align with CMS and NCQA standards. You will drive compliance, audits, and process improvements while supporting internal and external reviews. The role includes developing CMS/NCQA training, analyzing claims data for quality controls, and...

Centene Corporation in the United States is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation, and clinical quality initiatives. The role leads large-scale programs, collaborates across regions, and ensures compliance with standards while developing performance improvement activities. You will develop reports,...

Integrated Resources Inc. is seeking a Quality Manager to lead compliance efforts and quality management initiatives. The successful candidate will have a strong background in managed care and quality assurance, with proven leadership abilities and the capacity to foster inter-departmental collaboration. This role requires a Bachelor's degree and significant...

CareFirst BlueCross BlueShield is hiring an NCQA Quality Manager in Baltimore to oversee the NCQA Health Plan accreditation and lead initiatives to ensure compliance with national quality standards. The position requires a Bachelor's degree, 5 years of relevant experience, and strong data analytics skills. Responsibilities include leading a team, developing...

Centene Corporation is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation and clinical quality programs. This role leads large-scale initiatives, partnering across national, regional and multi-plan teams to improve care quality and member outcomes. The ideal candidate will have 3+ years of clinical/healthcare experience,...

Humana Inc. is seeking a Policy Governance Professional to manage the end-to-end Medicaid UM Rates and Timeliness evaluation and reporting process across applicable markets, including coordination with operational and clinical stakeholders. You will develop written evaluations, coordinate leadership review, and track follow-up actions and supporting...

Quality Improvement SpecialistOur organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and...

Job Description ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set,...

Quality Improvement SpecialistOur organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and...

Quality Improvement SpecialistOur organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and...

HEDIS Audit Quality Manager (State and NCQA Audits)Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and...

Blue Cross and Blue Shield of Kansas, Inc. seeks a Manager, Credentialing to lead credentialing and recredentialing operations for professional and institutional networks, ensuring timely, accurate, and compliant outcomes.You will develop strategy, oversee audits, ensure regulatory compliance, and collaborate across the enterprise to support provider network...

VIVA USA Inc. is seeking a Credentialing Specialist to guide clinicians through the client credentialing process in a fully remote U.S. environment. You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring compliance with NCQA, URAC, and state/federal requirements....

Job Description ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set,...

VIVA USA Inc. is seeking a Credentialing Specialist to guide clinicians through the client credentialing process in a fully remote U.S. environment.You will assist with credentialing applications, perform primary source verifications, and maintain the MD Staff credentialing database, ensuring compliance with NCQA, URAC, and state/federal requirements....

HEDIS Audit Quality Manager (State and NCQA Audits)Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and...

Humana is seeking a Credentialing Specialist to manage initial and recredentialing for providers, ensuring records are complete and compliant with NCQA, DHS, CMS, and internal policies. The role supports the WI Medicaid Market and collaborates across departments to resolve discrepancies and maintain network integrity. The position is remote with standard CST...

HEDIS Audit Quality Manager (State and NCQA Audits) Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and...

HEDIS Audit Quality Manager (State and NCQA Audits)Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and...