Accreditation and Compliance Specialist
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Job Description
Accreditation and Compliance Specialist overseeing licensing for Utilization Review state licenses. Supporting quality improvement initiatives and collaborating with stakeholders to ensure compliance in healthcare.
Responsibilities:
- Owner of interdepartmental coordination for monitoring and preparing submissions for Utilization Review (UR) state licenses
- Work closely with legal and other industry resources for regulatory research
- Collaborate with internal/external stakeholders for compliance information
- Support Sr. Director in developing quality improvement and utilization management initiatives
- Documenting and tracking all licensing requirements and application statuses
- Coordinate with legal to monitor state licensing requirements
- Assist with implementing quality improvement initiatives and maintaining RBUM policies
- Support accreditation program standards and client audits
Requirements:
- 2 or more years of experience in Accreditation and Compliance
- High School Diploma or GED (Required)
- Associate’s degree or equivalent experience in compliance (Preferred)
- CHC certification preferred
- Demonstrated ability to assume responsibility for daily activities and projects without direct supervision
- Demonstrated experience with written communications and document preparation
- Demonstrated organizational skills with strong attention to detail and quality.
- Experience with Utilization Management Licenses (Nationwide)
- Experience with NCQA/URAC accreditation
- Experience with internal auditing
Benefits:
- Health, dental, vision, life and disability insurance
- 401k retirement program
- Paid time off
- Participation in Premier’s employee incentive plans
- Tuition reimbursement and professional development opportunities
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