NCQA Quality & Accreditation Analyst

📋 Description

• Act as the project management leader and subject matter expert for NCQA standards.

• Oversee the evaluation of related business functions for relevant departments.

• Execute and track the accreditation workplan.

• Identify gaps and risks while providing regular status updates.

• Lead NCQA Accreditation reviews by collecting necessary documentation.

• Review and revise policies and procedures, reports, and materials to ensure compliance.

• Offer technical support and training to staff concerning NCQA Health Plan Accreditation.

• Evaluate business area functions against NCQA standards.

• Recognize and facilitate process enhancements.

• Communicate reporting deadlines and reminders to business leaders.

• Direct compliance reviews for non-clinical standards.

⛳️ Requirements

• Bachelor’s degree in healthcare, human services, public health administration, nursing, business, or a related field.

• Five (5) years of experience in managed care with knowledge and practical expertise in healthcare quality or NCQA Health Plan accreditation processes and requirements.

• Familiarity with NCQA Accreditation standards is preferred.

• Knowledge of regulatory reporting, compliance obligations, and auditing practices is preferred.

• Project management experience is preferred.

• Understanding of NCQA accreditation processes and standards.

• Knowledge of federal and state regulations.

• Exceptional communication skills (both written and verbal).

• Effective, respectful, and sensitive interpersonal skills for interacting with a diverse and multicultural population of children, families, and colleagues.

• Strong problem-solving, mediation, and conflict resolution skills.

• Ability to work collaboratively and as part of a team.

• Proficiency in Microsoft Project, Excel, Word (including edits and tracking), and PowerPoint.

🏝️ Benefits

• Medical.

• Dental.

• Vision.

• Life insurance.

• Long Term Disability.

• Generous retirement savings plan.

• Flexible work schedules including hybrid/remote options.

• Paid time off, including vacation, sick leave, holidays, and management leave.

• Dress flexibility.