NCQA jobs in Jackson Township, NJ

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

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

EHR Support Specialist

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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Contract, Third Party

Depends on Experience

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 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

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

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

Manager .NET Full Stack Engineering

Remote

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Today

Manager .NET Full Stack Engineering (Healthcare Provider Domain) Direct Hire Opportunity | No Visa Sponsorship Available (U.S. work authorization required). Job Summary We are seeking an experienced Full Stack Development Manager with strong expertise in the US healthcare provider domain to lead the design, development, and delivery of scalable, cloud-native applications. This is a hands-on technical leadership role requiring expertise in .NET/C#, React or Angular, AWS, healthcare interoperabili

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Full-time

Depends on Experience

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

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

Dot net Fullstack Manager

Remote

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22d ago

Manager Full Stack Development Experience: 1215 years Skillset: Provider Domain, Full Stack Development (.NET/C#, React/Angular), AWS, Healthcare Interoperability(HL7, FHIR, X12 EDI), AI-Assisted Engineering, Onshore/Offshore Delivery Leadership Role Overview We are looking for a Manager of Full Stack Development with deep expertise in the US healthcare provider domain to lead design, development, and delivery of complex, high-availability applications on .NET/C# and modern front-end frameworks

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Full-time

Depends on Experience

Data Scientist - CAHPS Analytic

Remote

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Today

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health

Full-time

USD 149,882.00 - 224,823.00 per year

Hiring! Senior Director, Product Management - Interoperability (Healthcare Domain Only)

Remote or Texas

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Today

Senior Director, Product Management - Interoperability Level: Senior Director Team: Interoperability Reports To: SVP, Product Management - Data Interoperability Employment Type: Contract to Hire Location: USA, Remote About the Role We're looking for an execution-focused product leader to serve as the senior partner to the SVP of Product Management, Data Interoperability. In this role, you'll help refine product strategy and drive delivery of high-quality interoperability products across a

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Full-time, Contract, Third Party

Manager, Application Admin

Remote

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Today

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): 601 Elmwood Ave, Rochester, New York, United States of America, 14642 Opening: Worker Subtype:

Full-time

USD 97,400.00 - 146,000.00 per year

Senior Data Engineer - Remote

Remote or Eden Prairie, Minnesota

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Today

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care's most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. The Optum Hea

Full-time

USD 91,700.00 - 163,700.00 per year

NCQA jobs in Jackson Township, NJ, USA