NCQA jobs | Dice.com

Remote

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Yesterday

Job ID: NC-814056 Remote EHR Support Specialist (12+) with Epic/Cerner/Oracle Health/Allscripts/Veradigm/NextGen, HL7/C-CDA/CCD/FHIR/USCDI, clinical data/workflow, privacy/Security, HIPAA, SQL, HIEA/Exchange/Medicaid QPHE/NCQA/DAV experience Location: Raleigh, NC (NCDIT) Duration: 84 Months Skills: Experience with Electronic Health Record platforms such as Epic, Cerner/Oracle Health, Allscripts/Veradigm, or NextGen. Required 5 Years Proficiency with healthcare interoperability standards includin

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Third Party, Contract

Depends on Experience

EHR Integration Specialist

Remote

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Today

Title:EHR Integration Specialist Location:RemoteLength:Long termRestriction:w2 or c2cDescription:Interview Type: Webcam Interview Only Very long term project; initial PO for 1 year, expect to go for 4+ years Remote Job Description: Key ResponsibilitiesEHR Integration & Technical OnboardingLead rural provider onboarding to NC HealthConnex, guiding organizations and EHR vendors through connection requirements, HL7 v2 exchange, C-CDA/CCD exchange, and services such as NC*Notify.Conduct technical a

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Contract

Depends on Experience

Credentialing Coordinator

Jackson Township, New Jersey

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2d ago

APN Consulting, Inc. is a progressive IT staffing and services company offering innovative business solutions to improve client business outcomes. We focus on high impact technology solutions in ServiceNow, Fullstack, Cloud & Data, and AI / ML. Due to our globally expanding service offerings we are seeking top-talent to join our teams and grow with us. Role: Credentialing Coordinator Location : R emote Duration: 12/31/26 Position Summary The Credentialing Coordinator will contribute with the p

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Contract, Third Party

$21

Clinical Coordinator

Remote or Hybrid in Florida City, Florida

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14d ago

Avanciers Incorporated is hiring a Clinical Coordinator for one of our clients. Role: Clinical CoordinatorLocation: Florida / Remote (as applicable)Experience: 15 years of clinical nursing experienceRequired License: Active, unrestricted Florida RN License or Compact RN LicenseJob Description:Reviews and investigates member and provider appeals involving clinical/medical necessity denials.Analyzes medical records, claims history, and clinical documentation against InterQual/MCG criteria to deter

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Contract

Depends on Experience

Clinical Medical Review Nurse

Remote

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23d ago

Clinical Medical ReviewNurse (HEDIS Medical RecordsRetrieving) Columbia, MD (Primarily remote, but hybrid) 6 Months+ PURPOSE: Seeking a qualified RN or LPN with experience supporting HEDIS reporting and abstraction processes in a payer, health insurance, or HEDIS vendor environment. The ideal candidate will understand NCQA healthcare quality metrics and have a proven ability to accurately abstract, interpret, and document medical record data for HEDIS gap closure. This role will support me

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Contract, Third Party

Depends on Experience

Senior Health Plan Medical Director (Physician Role)

Washington, District of Columbia

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Today

Pay: $275,000 ? $300,000 per year Schedule: Full Time, Day Location: MedStar Georgetown - 2233 Wisconsin Ave MedStar Job ID: 171915 Senior Health Plan Medical Director - MedStar Family Choice, Washington DC We are looking for a physician with senior level health plan experience to join MedStar Family Choice, our Medicaid Managed Care Organization, as the Senior Health Plan Medical Director in Washington, DC. Key Position Details This position serves as a key thought partner and advisor to the

Full-time

Compensation information provided in the description

Clinical Medical Review RN OR LPN (HEDIS)

Hybrid in Columbia, Maryland

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Today

The Clinical Medical Review Specialist (a professional with clinical experience) will report to the Clinical Support Supervisor HEDIS and be part of the Quality Team. The main duties include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA specifications, retrieval follow-up, and escalating issues as needed. Main duties will be assigned according to experience, knowledge, skills, and abilities. This role requires extensive knowled

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Contract

Depends on Experience

Senior Manager, Credentialing & Provider Data Analytics

Remote or Missouri

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Today

Position Purpose: The Senior Manager of Credentialing and PDM will oversee all direct processes of credentialing and provider data entry, from triage through provider enrollment and data maintenance. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Preferred

Full-time

USD 87,700.00 - 157,800.00 per year

PSO Privacy and Security Policy Writer

Rocky Mount, North Carolina

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Yesterday

CCS Global Tech is a rapidly growing Information Technology company with a diverse portfolio of technology products and services and a large network of industry partnerships. With over 22 years of being a successful business with a global talent pool and presence, CCS is a certified Microsoft Gold Partner and specializes in delivering expert Microsoft based solutions for technical and business needs. We have been recognized by Inc. 500 Magazine as one of the fastest growing small companies in th

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Third Party, Contract

Provider EHR Support Specialist

Rocky Mount, North Carolina

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Yesterday

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Third Party, Contract

NCDIT HIEA RHT Provider EHR Support Specialist

Remote

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Yesterday

NCDIT HIEA RHT Provider EHR Support Specialist (814056) Raleigh, NC (100% Remote) Interview Type: Webcam Interview Only Skill Required / Desired Amount of Experience Years of Experience Experience with Electronic Health Record platforms such as Epic, Cerner/Oracle Health, Allscripts/Veradigm, or NextGen. Required 5 Years Proficiency with healthcare interoperability standards including HL7 v2, C-CDA, CCD, FHIR, and USCDI. Required 5 Years Experience validating structured clinical data and trouble

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Contract

Depends on Experience

HIM Supervisor

Remote

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Today

Immediate need for a talented HIM Supervisor. This is a 06+months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:26-18819 Pay Range: $37 - $39/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Develop and implement workflow systems for accur

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Contract

37 - 39

EHR Support Specialist

Remote or Hybrid in North Carolina

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Today

Phone/Skype Hire. REMOTE Location: Raleigh, NC / Remote Duration: 12+ months This position focuses on assisting rural and underserved healthcare organizations in connecting to, and fully utilizing, the state's health information exchange. The Specialist provides expertise in Electronic Health Records (EHRs), healthcare interoperability, clinical workflow integration, and data quality improvement to ensure providers submit accurate, standards aligned clinical data that supports statewide care co

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Contract

EHR Support Specialist - REMOTE

Remote

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2d ago

Job Description: Crop to Crop resumes are accepted The NC HIEA RHT Provider EHR Support Specialist is a key technical role supporting North Carolinas Rural Health Transformation Program (RHTP). This position focuses on assisting rural and underserved healthcare organizations in connecting to, and fully utilizing, NC HealthConnex, the states health information exchange. The Specialist provides expertise in Electronic Health Records (EHRs), healthcare interoperability, clinical workflow integratio

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Contract, Third Party

Depends on Experience

Senior Health Plan Medical Director (Physician Role)

Columbia, Maryland

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Today

Pay: $275,000 ? $300,000 per year Schedule: Full Time, Day Location: MedStar Health - Corporate (Columbia) MedStar Job ID: 170442 Senior Health Plan Medical Director/Medical Officer, Baltimore, MD - MedStar Family Choice We are looking for a physician with senior level health plan experience to join MedStar Family Choice, our Medicaid Managed Care Organization, as the Senior Health Plan Medical Director/Medical Officer in the Baltimore, MD region. Key Position Details This position serves as

Full-time

Compensation information provided in the description

Clinical Data Audit Consultant

Remote or California

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Today

Position Purpose: The Clinical Data and Audit Consultant is responsible for the clinical content component of all data collection, account implementations, and audit activities for Clinical Operations to ensure high-quality tracking and performance of the service teams. Key Details: Registered Nurse - Must be currently licensed in CA. Pacific Time Zone Work Hours The Consultant gathers and analyzes data, creates workflows, coordinates internal and external audits, and analyzes and documents bu

Full-time

USD 33.71 - 60.67 per hour

Sr Data Engineer

Eden Prairie, Minnesota

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Today

Our Company Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, and data they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us

Full-time

USD 91,700.00 - 163,700.00 per year

Medical Informatics Analyst - EMR Data Integration, Operations & Analytics

Detroit, Michigan

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Today

Job Description Provides technical, data and analytical support to customer departments such as Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment and HCV. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Leads or participates, with some direction, in projects where data solutions are necessary.Provides programming and data expertise for simple and moderately complex projects and ad-hoc requests.Presents data and solut

Full-time

Associate Director - QOI Supplemental Data Operations - Remote CST or EST

Remote or Minnetonka, Minnesota

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Today

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. The Associate Director,

Full-time

USD 112,700.00 - 193,200.00 per year

FACETS Architect (with Healthcare Claims)

Remote

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Today

Remote Job Contract to Hire Important Notes from HM: Proficiency in innovating ideas and solutions resulting in tangible and measurable business outcomes. Mastery in creating architecture solutions within the enterprise architecture future state for technological acceleration of value outcomes, and effectively present and persuade key decision makers to invest in this acceleration. Must have recent solution/domain architecture experience with Facets G6 real-time and batch claims processing,

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Contract

$80 - $90