Accreditation Specialist II
| Company | Centene |
|---|---|
| Location | Kansas, USA, Texas, USA, Florida, USA, Mississippi, USA, Tennessee, USA, Minnesota, USA, Kentucky, USA, Missouri, USA, United States |
| Salary | $68700 – $123700 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Mid Level, Senior |
Requirements
- Bachelor’s degree in Business, related field or equivalent experience
- 4+ years of related quality and process improvement, operational experience in applicable business area
- HEDIS and/or NCQA experience
- Accreditation experience preferred
Responsibilities
- Leads quality improvement activities by coordinating and performing activities related to the scheduled surveys for accreditation readiness
- Develops accreditation activities including but not limited to policies, procedures, workflows, and templates for assigned standards within their market portfolio in collaboration with corporate and market business partners
- Acts as a subject matter expert and provide education/guidance to direct development of compliant processes, projects, and monitoring of performance on accreditation standards to primary business owners
- Ensures consistency of accreditation standards interpretation and process implementation
- Creates, reviews, and finalizes projects with associated documents to ensure they meet quality standards and accreditation requirements in coordination with the markets and corporate
- Prepares final survey submission documents validating for quality and accuracy including content compliance with accreditation and annotating and bookmarking standards
- Initiates appropriate criteria-based accreditation reviews, follow-up, and sustainment to ensure compliance with standards, directives, or regulations
- Identifies, documents, and assesses compliance risks and works collaboratively with key functions across the organization to drive organizational change to improve quality and ensure compliance with the accrediting body (i.e., NCQA)
- Serves as the primary point of contact for accreditation and regulatory activities. Responsible for tracking, reporting, and ensuring the completion of action items resulting from internal and external assessments / findings related to accreditation
- Communicates with multi-level stakeholders, providing guidance to reduce risk within the organization and collaborates with senior management to identify risk issues and address appropriately as needed
- Analyzes data and implements action for the purpose of improving accreditation management at the service and facility level
Preferred Qualifications
- Accreditation experience preferred