Accreditation Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Initiate Performance Improvement initiatives aimed at enhancing clinical quality and performance measure outcomes.

• Establish and oversee delegation oversight mechanisms, serving as the liaison between the Plan and Corporate Delegation Oversight.

• Develop and uphold a schedule for accreditation readiness.

• Formulate policies and procedures that facilitate accreditation activities.

• Implement training and educational programs for the Plan, provider network, and delegated vendors to support NCQA and HEDIS initiatives.

• Create QI, NCQA, and HEDIS projects in collaboration with delegated vendors to maintain accreditation and support HEDIS reporting.

• Manage assigned NCQA and HEDIS work plan activities.

• Assist in conducting delegation oversight audits.

• Coordinate corrective action plans to ensure adherence to all state, federal, contract, and accreditation standards.

⛳️ Requirements

• Must possess authorization to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Bachelor's degree in Business, a related field, or equivalent experience.

• A minimum of 3 years of relevant experience in quality improvement, HEDIS, and/or NCQA.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase plans available.

• Tuition reimbursement opportunities.

• Paid time off along with holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.