Accreditation Specialist
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Job Description
Accreditation Specialist improving clinical quality and accreditation readiness for Centene, a healthcare solutions provider. Coordinating NCQA, HEDIS, delegation oversight, audits, and corrective action plans.
Responsibilities:
- Develop Performance Improvement projects to improve clinical quality and performance measure outcomes
- Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight
- Develop and maintain accreditation readiness schedule
- Create policies and procedures to support accreditation activities
- Conduct training and education programs for Plan, provider network, and delegated vendors to support NCQA and HEDIS activities
- Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting
- Coordinate assigned NCQA and HEDIS work plan activities
- Assist with delegation oversight audits
- Coordinate corrective action plans to ensure compliance with all state, federal, contract, and accreditation requirements
Requirements:
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- Bachelor's degree in Business, related field, or equivalent experience
- 3+ years of related quality improvement, HEDIS and/or NCQA experience
Benefits:
- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
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