Posted in Nonprofit - Social Services 10 days ago.
Type: Full-Time
Location: Morrisville, North Carolina
Under the direction of the Accreditation Manager, the NCQA Quality & Accreditation Specialist serves as the project management lead and subject matter expert for assigned NCQA standard areas and manages the assessment of related business functions for corresponding departments within the scope of NCQA standards (e.g. Provider and Member Services, Utilization Management, Population Health, Care Management, Provider Network, Member and Provider Communications, Delegation Oversight) to support high-quality performance and ensure successful NCQA Accreditation process.
This position will allow the successful candidate to work fully remotely. There is no expectation of being in the office routinely; however, the hire has the option to report to the office as needed.
Responsibilities & Duties
Implement and Monitor Accreditation Workplan
Drive Organizational Accreditation Efforts
Minimum Requirements
Education & Experience
Graduation from an accredited school of nursing and three (3) years of project management experience in a managed care or healthcare setting with knowledge and practical experience on NCQA Health Plan accreditation processes and requirements.
Or
Bachelor’s degree in Healthcare, Human Services, Public Health Administration, Business, or related field and three (3) years of project management experience in a managed care or healthcare setting with knowledge and practical experience NCQA Health Plan accreditation processes and requirements.
Clinical experience as an RN and preferably a Care Management background
Knowledge of regulatory reporting, compliance requirements, and auditing procedures
Knowledge, Skills, & Abilities
Salary Range
$66,240- $84,456/Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
An excellent fringe benefit package accompanies the salary, which includes:
See job description
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