• NCQA Quality

    Integra Partners (Troy, MI)
    The Quality & Accreditation Specialist is responsible for coordinating and maintaining accreditation activities for the Utilization Management (UM) and ... Credentialing departments. This includes supporting NCQA accreditation , implementing quality monitoring initiatives, conducting internal reviews, and… more
    Integra Partners (12/02/25)
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  • Accreditation , Regulatory, and Licensing…

    Columbia Memorial Hospital (Astoria, OR)
    ELIGIBLE FOR CMH EMPLOYEE REFERRAL BONUS: NON-PRIORITY RECRUITMENT The Accreditation , Regulatory, and Licensing Nurse Specialist ensures compliance with ... Oregon State Board of Nursing Preferred: Certified Professional in Healthcare Quality (CPHQ). Preferred: Credential(s) from the Healthcare Accreditation more
    Columbia Memorial Hospital (12/02/25)
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  • Quality Improvement Specialist

    Centene Corporation (Atlanta, GA)
    …workplace flexibility. **Position Purpose:** The Senior Quality Improvement Specialist is responsible for coordinating assigned regulatory, accreditation , ... care experience in a health care environment Experience in compliance, accreditation , service or quality improvement Complex project management experience… more
    Centene Corporation (11/26/25)
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  • Senior Specialist , Quality

    Molina Healthcare (Rockford, IL)
    …key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ... **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist , Quality Interventions / QI Compliance contributes to one or more of these quality improvement… more
    Molina Healthcare (11/21/25)
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  • Credentialing and Provider Enrollment…

    BayCare Health System (FL)
    …State and Federal guidelines and regulations, as well as department policies. Assist in the NCQA Accreditation renewals and Managed Care plan NCQA and CMS ... quality standards. + Identifies issues and trends in quality measures and Credentialing Specialist performance and...and trends in quality measures and Credentialing Specialist performance and reports that information to the Supervisor… more
    BayCare Health System (11/14/25)
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  • Clinical Quality and Regulatory…

    Highmark Health (Pittsburgh, PA)
    …respect to regulatory requirements and corporate policies/procedures. (Ex: operational audits, quality improvement audits, accreditation mock audits, etc.) + ... activities are compliant with regulatory guidelines/agencies, including but not limited to: NCQA , CMS, DPW, and DOH. Supports the integration of new vendors and… more
    Highmark Health (11/15/25)
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  • Specialist , Quality

    Molina Healthcare (Savannah, GA)
    …key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ... **KNOWLEDGE/SKILLS/ABILITIES** The Specialist , Quality Interventions/ QI Compliance contributes to one or more of these quality improvement functions: … more
    Molina Healthcare (11/21/25)
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  • Credentialing Specialist - Medical Staff…

    Henry Ford Health System (Jackson, MI)
    …understanding of medical staff credentialing and regulatory requirements. Experience with accreditation standards (eg, Joint Commission, NCQA , URAC, HFAP). ... Credentialing Specialist - Medical Staff Affairs - Days Location:...medical staff meetings, and ensuring compliance with regulatory and accreditation standards. The coordinator serves as a key resource… more
    Henry Ford Health System (11/29/25)
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  • Network Management Specialist (Contract…

    Magellan Health Services (Albuquerque, NM)
    …description. Other Job Requirements Responsibilities Knowledge of National Committee for Quality Assurance ( NCQA ) requirements. Ability to work independently and ... The Network Contract Specialist will be responsible for creating and maintaining...+ Rate updates + Letters of Direction (LODs) + NCQA /CAQH + Ensure compliance with internal standards and state-specific… more
    Magellan Health Services (11/13/25)
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  • Customer Solution Center Appeals and Grievances…

    LA Care Health Plan (Los Angeles, CA)
    …Managed Risk Medical Insurance Board (MBMIB) and National Committee for Quality Assurance ( NCQA ) regulatory requirements. This position reviews pre-service ... Customer Solution Center Appeals and Grievances Specialist II (Temporary) Job Category: Customer Service Department:...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
    LA Care Health Plan (11/06/25)
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